Junior Doctors Contract

Liz McInnes Excerpts

Friday 20th November 2015 Commons Chamber

[Alistair Burt]

I am quite sure I can say to my hon. Friend that no one ever wants to see anyone hurt, but, if there is a withdrawal of labour, it is not possible to say that certain procedures to relieve the discomfort of existing patients will take place. That is obviously the point of the action and why no one wishes to see it happen. I repeat that no doctor wishes to put a patient in a situation of harm. No Minister wants to see that and none of us here does. This process has been going on for three and a half years; there has been reference to independent people, recommendations that the BMA played a part in making and an open offer always to come back to negotiations. That does not seem an unreasonable position for the Secretary of State to take. That is why it should be backed by everyone sitting in the House today.

[Liz McInnes (Heywood and Middleton) (Lab)]

Negotiations have clearly reached an impasse, and winter pressures and a winter crisis in the NHS are looming. In the interests of patient safety, let us bring in ACAS. Talks have clearly stalled. If the Secretary of State is doing everything he can, will the Minister tell me where he is today?

[Alistair Burt]

The impasse was not created by the Secretary of State. The impasse was created by the BMA walking away from negotiations last year and not returning to negotiations after the recommendations of the independent body came through. That is not an impasse; that is one side deciding it does not want to take part. The Secretary of State’s response has been to say: keep the negotiations going, the door is always open.

The hon. Lady asks where the Secretary of State is today. He is working on the spending review plans for the support the NHS needs—a financial commitment the Labour party did not make at the general election. He is also working on contingency plans to make sure the NHS is safe if action takes place. I think that is pretty important work that he should be doing.

Male Suicide and International Men’s Day

Liz McInnes Excerpts

Thursday 19th November 2015 Westminster Hall

[Philip Davies]

I am very grateful to my hon. Friend for that intervention. I am sure that we all hope that my right hon. Friend the Minister will deal with that point when he makes his contribution to the debate.

Shockingly, 56.1% of men who commit suicide do so by hanging themselves. I cannot imagine the horror of finding someone who has hanged themselves. Add to that the fact that that person is a loved one and it is even more tragic. Then, there are all the questions that inevitably arise following a suicide from the person’s loved ones. Why? Why did I not know there was something wrong? Why did they not talk to me? Why did they leave me? What could I have done to prevent this from happening? The guilt and sense of loss that those left behind must feel after someone has killed themselves should be reason enough to want to do something, never mind the absolute waste of life of the individual concerned. Suicides account for more deaths than road traffic accidents, so one would expect the Government to be trying to tackle this issue.

Sometimes this place is also about sending out signals or messages, and the message that I want to go out loud and clear today to anyone contemplating suicide is: you are not alone. There is nothing whatever weak or wrong in seeking help, and there are plenty of people out there who can help you, so please talk to someone—confidentially and anonymously if you prefer, but please talk to someone. Suicide is never the right option.

The Royal College of Psychiatrists says:

“We also need to work towards building a society where people should not be afraid to seek help for fear of being stigmatised and where the media agree to responsible reporting of suicide.”

I could not agree more. It says that it is also important that information on depression and how men can get support is available in what might be traditionally considered male settings, such as football stadiums, barbers or pubs. Again, that seems like a very good idea.

Suicide, especially in the numbers that we see for men, is a huge, tragic problem, and we need to work together to achieve change. One thing that leads men to contemplate suicide is the breakdown of a relationship, especially if children are involved. It is clear that the courts are more likely to place children with the mother than with the father. This is a massive area where men face very different treatment from women. We underestimate the effect on fathers of having to battle to see their children and facing the inevitable likelihood that they will come off worse simply because of their gender.

I am certainly not saying that all cases are like that. Many, many reasonable mothers allow the father as much access to the children as possible, and we should always recognise that, but life is not always that simple in every relationship. Some women do use their children as a stick to beat the father with—perhaps because they are bitter about the failed relationship, because of financial reasons, or because they have moved on and it is easier for them if their new partner takes on the role of father to their children. Women can fail to put the father on the birth certificate, limiting his rights, or lie to him about whether he is even the father. Short of a child-swapping disaster in hospital, women know for sure that their babies are their own, but fathers can never know 100% that that is the case without a formal DNA test. Many are sure because of their trust in their partner, but plenty will be unsure because of their partner’s behaviour, or because they have been deliberately tricked.

I have received numerous messages on the subject of fathers and their children. Unfortunately, we do not have time to go through them all, but I will read out one or two that contain the points that many people have made and that link the serious issues of fathers not having access to their children to the issue of suicide. One person said:

“Dear Mr Davies,

A number of local fathers have been in touch with…our MP, as I have over the years, about the way fathers are routinely excluded from their children’s lives or treated very differently from mothers.”

This was from a constituent of my hon. Friend the Member for Kettering (Mr Hollobone), and the person said that they were delighted that my hon. Friend had helped us to secure this debate. They continued:

“It’s been proved time and again that children benefit from parenting by both their parents after separation but it is all too easy for false allegations to be made in an attempt to exclude fathers. There are rarely any repercussions and it can be many months before broken relationships with children can be mended—if ever.

Sadly, I know a number of men who have been driven to suicide as a result of their experience. Many fathers I meet at the local meeting I chair have mental health problems associated with separation and the difficulties they have experienced. And that’s aside from other members of their families including of course grandfathers, of whom my husband is one.

I do hope something positive comes from the debate on Thursday”.

That is from Jenny Cuttriss, chair of the Families Need Fathers branch in Kettering.

Messages from other people on the subject include one saying:

“I have spent the last 4 years going through the Family Courts trying to maintain a decent relationship with my children. Over and over again my ex has been emotionally abusing my daughter and alienating me from her life… She has also maliciously claimed DV”—

domestic violence—

“and taken out a Non-Molestation order against me to try and stop me…having contact or being involved in my daughter’s life in retaliation to me getting my ex’s mother arrested for assault as she attacked me inside a court building.”

I had been aware of the stories about men’s chances when it comes to custody of their children for some time, so last February I asked the Ministry of Justice

“in what proportion of all cases heard in family courts where both the mother and father sought custody of their children the residence order was awarded to (a) the mother, (b) the father and (c) jointly”.

The answer from the then Minister was:

“The information…does not record details of the orders…such as which…parties were awarded the order. The information requested can only be obtained…at disproportionate cost.”—[Official Report, 24 February 2014; Vol. 576, c. 261W.]

However, from everything that I have heard, including from those who actually do the adjudicating in family courts, it seems that it takes something out of the ordinary for men to be awarded custody of their children, and it seems that the Ministry of Justice cannot say otherwise. The Equality Act 2010 does not seem to apply in this area.

If people think men have life easy, they need to think again when it comes to families. Women have an awful lot of control, and there is an inbuilt bias towards them when it comes to the very important job of raising children. It does not look as though that is going to change anytime soon, yet as someone wrote in a message to me,

“I really believe that if this system worked against women the way it works against men there would be hell on about it! Whenever there is any discussion of gender inequality the focus is solely on women being disadvantaged…and never about these inequities or those that you yourself raise or the many other areas where men are disadvantaged.

The fact that women usually take responsibility for childcare is often cited as an obstacle to women’s progression in their careers and…under representation in senior roles and I believe society’s perceptions and family law appear to be perpetuating this issue. Perhaps more equality in family law and wider society could prove a win-win for both sexes?”

That seemed to me a very good point.

[Liz McInnes (Heywood and Middleton) (Lab)]

I am very grateful to the hon. Gentleman for securing this important debate, but I feel that the evidence that he has just presented is anecdotal; there is no concrete evidence. He has given us just individual cases, and I am concerned that this discussion is straying down a slightly misogynistic route.

[Philip Davies]

I am sorry that the hon. Lady feels like that. Again, it is part of the politically correct culture that we have in this place that the moment anybody raises anything that affects men, people are accused of being misogynists. That is part of the problem; the hon. Lady is part of the reason why these issues never get debated. It is raised to try to deter anybody from ever raising their head above the parapet. Many people in her constituency are affected by these issues. Perhaps she ought to go and consult some of her constituents about the problems they face in these areas. She might learn that it is right to raise these issues in Parliament. It is not misogynistic to raise the issues faced by some fathers in her constituency who are having trouble getting custody of or access to their children. If she does not think that that is a problem, she needs to get out more, frankly.

--- Later in debate ---

[Mr Nuttall]

I am very grateful for that intervention, because that vignette highlights a lot of the problems. The mere fact that we are holding this debate—it may not be in the main Chamber, but it is here in Westminster Hall—and are able to discuss the subject will hopefully generate some wider debate outside Parliament. It might make it just that little bit easier for the debate to take place in wider society.

As I was saying, I approached the debate today with some trepidation, because, as has just been amply demonstrated by the hon. Lady, who is chair of the all-party group on suicide and self-harm prevention, many organisations and people seem to be looking at this problem—governmental bodies, other public sector bodies, charities in the independent sector and academics—and all have greater experience than I have, but I have looked at it with fresh eyes. Part of the reason why I am here today is that I am staggered by the intransigence of the problem. Clearly, there are many people looking at it, but the reality is that the number of male suicides has remained pretty stubborn over decades. This is not a party political point. It does not matter whether there was a Conservative Government under Mrs Thatcher or a Labour Government under Mr Blair; the numbers for male suicide have stayed pretty much the same. That made me think that there is something serious going on here that is wider than just the typical argument about party politics.

I pay tribute to the charity CALM—the Campaign Against Living Miserably—because it has provided some helpful briefing and figures for this afternoon’s debate. CALM says that in 2014 more than three quarters —76%—of suicides were men. That is 4,623 deaths. It is worth repeating that suicide is the biggest single killer of men under the age of 45. For deaths registered in 2013, the last year for which the Office for National Statistics has figures, my own region—the north-west of England, in which my constituency is situated—had a male suicide rate of 21.2. That is the second highest rate in the country, second only to the north-east. The experts will be aware that the rates are invariably quoted in the statistics as a rate per 100,000 of population, so that is 21 people out of every 100,000. As always with these statistics, there is a host of caveats and technical details that could be explored, but I do not think we should let the minutiae obscure the big picture, which is that while the suicide rate in the north-west among men was 21.2, the rate among females was 6.3. A rate of 21 against a rate of 6 is a big difference indeed.

[Liz McInnes]

I thank the hon. Gentleman for talking so sensitively about this issue. I, too, am greatly concerned about male suicide, and that is why I came to this debate. He speaks very knowledgably about the rates of male suicide, but is he aware that young gay men are six times more likely to take their own life than their straight male counterparts?

[Mr Nuttall]

I have heard that statistic twice today, the first time in the Chamber, when the shadow Leader of the House made that point. I do not know whether the statistic is correct, but I am prepared to accept what the hon. Lady and the shadow Leader of the House say. I am sure that of those more than 4,000 deaths, some were gay men and some were young gay men. That may well be one of the contributing factors.

The charity CALM has set out four areas where it thinks action should be taken. First, and quite understandably, it states that there is a need for timely and accurate information. That could be applied to many things across Government. It always amazes me how long it takes for what, on the face of it, are fairly simply statistics to be collated and reach the public domain. Secondly, and again understandably, CALM says that we need to understand the reasons why people take their own life, because there is a strong element of contagion, which the hon. Member for Bridgend mentioned. Thirdly, CALM wants all local authorities to develop and implement a suicide prevention plan, and says that those that do not should be named. Fourthly, it states that if national and local suicide prevention plans are to be effective, there must be some accountability—there is no point having a plan unless something is done if that plan is not adhered to.

It is worth noting that in its own way, CALM has tried to give the issue some publicity through social media and the #BiggerIssues campaign, which is an advertising campaign to draw attention to the fact that as a society we tend to pay an inordinate amount of attention to perhaps relatively trivial topics, such as the weather and the sort of coffee we are drinking, rather than to male suicide, which is a real problem in society. The campaign has created digital posters featuring the hashtag #BiggerIssues, which were posted across the UK. Those posters changed every two hours to reflect the fact that every two hours, a man takes his own life. The campaign was run in association with the men’s grooming brand Lynx, and I think we should pay tribute to whoever it was who took that brave decision to link a men’s grooming product with the campaign. Others perhaps looked at it and thought, “The issue is a bit too touchy for us. We’ll leave that one alone.” Whoever was involved at Lynx, we should publicly thank them for being able to associate their brand with that particular campaign.

I was surprised to find that this phenomenon is not unique to this country. Right across the world and in almost every country, there is the same stark difference in the suicide rates. Lithuania, Russia, Japan, Hungary, Finland—almost everywhere we look, the picture is the same: male suicides considerably outnumber female suicides. Apparently that is not the case in China. I am not an academic; I have not spent time looking into this, but it seems to me there may be something in the fact that in one country, China, it is the other way around that may in years to come offer a solution to the problem.

We are a Parliament with different political parties, and for our own reasons we try to make party political points. When I have previously raised this issue, people immediately say, “Of course, it’s all the Government’s fault. The fact that there are lots of men committing suicide is all your Government’s fault, because you are making cuts to public services and you are cutting the NHS”—which is not true; more money is being spent on the NHS than ever before, so that argument immediately falls. Those arguments are easy to make. It is simple to throw out that it is all the Conservatives’ fault, but as I will demonstrate, the statistics—the facts—from the Office for National Statistics simply do not bear out that argument.

In the 1980s, under the Conservatives, the number of male suicides each year was somewhere between 4,000 and 5,000. It did vary a little bit—it got down as low as 4,066 in 1982 and it went up to 4,370 in 1987—but every year it was between 4,000 and 5,000. Between 1997 and 2010, under the Labour Government, the number of male suicides was somewhere between 4,000 and 5,000. Again, it varied—some years it was down, and some years it was up—but every year it was somewhere between 4,000 and 5,000. What is noticeable is that the gap between male and female suicide rates has been increasing steadily in almost every single year since 1981. At the start of this range of statistics, the male rate was a bit less than double the female rate—about 1.78 male suicides for every female suicide, I think.

Off-patent Drugs Bill

Liz McInnes Excerpts

Friday 6th November 2015 Commons Chamber

[Nick Thomas-Symonds]

I agree entirely with my hon. Friend.

[Liz McInnes (Heywood and Middleton) (Lab)]

We are talking about people who support the Bill. The Association Of the British Pharmaceutical Industry says that it supports the principle of the Bill, but that it is concerned that it could discourage the development of new medicines. Does my hon. Friend agree that the Bill in no way precludes the normal process of research and development for the manufacture and discovery of new drugs?

[Nick Thomas-Symonds]

I agree entirely with my hon. Friend. Repurposing is becoming increasingly common. Approximately 10% of the Brain Tumour Research portfolio is in repurposed drugs. For the Cure Parkinson’s Trust, the figure is 50%, and for the Alzheimer’s Society it is 13.6%. My hon. Friend makes a powerful point.

Hospital Parking Charges (Exemption for Carers) Bill

Liz McInnes Excerpts

Friday 30th October 2015 Commons Chamber

[Philip Davies]

The hon. Lady is approaching this Bill as if nobody at the moment does any caring and if we have this Bill everyone will start caring and save the NHS billions of pounds. The point is the people—

[Liz McInnes (Heywood and Middleton) (Lab)]

Will the hon. Gentleman give way?

[Philip Davies]

I will deal with the first intervention first, then I will give way to the hon. Lady; there is plenty of time.

On those people who are saving the NHS millions of pounds—I think I made very clear at the start of my remarks how much we all rely on carers—they are already saving the NHS that money. This Bill does not come with any savings to the NHS. This Bill only comes with a cost to the NHS. If the hon. Member for Ealing Central and Acton (Dr Huq) cannot see that, she really needs to go and look at the Bill again, because that is clear to everyone. She may well want to argue that it is a worthwhile cost to the NHS, and I am perfectly prepared for her to make that case, but people should not be claiming that this is a cost-saving Bill for the NHS because it is anything but.

[Liz McInnes]

The hon. Gentleman seems to know the price of everything and the value of nothing. Did he not hear my hon. Friend the Member for Burnley (Julie Cooper) talk about Torbay hospital and the benefits that it has found the scheme brought to the hospital in terms of patient care and wellbeing, which is surely what hospitals are about? They are not about charging people to park.

[Philip Davies]

If I might be able to make some progress, which I am always keen to do on these occasions, I will come later to the situation at Torbay, because it is very interesting and does not make the case for this Bill as the hon. Lady seems to think.

It has also been interesting to learn from these exchanges that whereas not that long ago during the passage of a different Bill the Labour party claimed it very much supported the principle of localism—that it was the champion of localism and devolution and it wanted to jump on that agenda—today, early on in this Parliament, when we actually have localism in action, where local hospitals can make decisions which they think are in the best interests of their local residents and local patients, the Labour party goes back to type and wants to centralise everything.

[Philip Davies]

My hon. Friend is right, and my understanding was that the Labour party in Manchester was in favour of devolution and it had agreed to the devolution package the Chancellor had proposed. I suspect it could not ever have got off the ground if the Labour party in Manchester had not been supportive of it. The whole purpose of devolution is to allow local decision making on things such as the NHS, and presumably as part of that car parking charges within the NHS, yet it seems that at the first step the Labour party wants to take the whole devolution agenda from under the feet of the locally elected people before it has even started.

[Liz McInnes]

Is the hon. Gentleman not aware that, although car parking charging decisions are made locally by individual hospital trusts, they follow the Government’s guidelines?

--- Later in debate ---

[Liz McInnes (Heywood and Middleton) (Lab)]

I should like to declare my support for the Bill, and I congratulate my hon. Friend the Member for Burnley (Julie Cooper) on bringing it to the House today. We have had an interesting debate. It has been enlightening for me; I am not often here on Fridays, and I have been intrigued by the way in which the discussions have gone on.

My hon. Friend made a good point about the amount of money that carers save the NHS as a result of the unpaid voluntary work they do, attending hospitals, caring for friends, relatives and loved ones and relieving the pressure and stress that our support workers, nurses and doctors are under. When we talk about money resolutions and finance, we need to remember that not everything has a financial cost. We cannot put a price on everything, and the amount that carers save our NHS is priceless. It is not something we can quantify. However, I certainly agree with my hon. Friend that the amount of money that carers save our NHS is far over and above what they might bring in in car parking fees.

I am speaking from the point of view of a former NHS worker. I used to work at North Manchester general hospital, which is now part of Pennine Acute Hospitals Trust to which the hon. Member for Bury North (Mr Nuttall) referred. He spoke about the trust as something of an exemplar in the way that it advertised car parking to patients and visitors. Having worked there for a long time, my experience is that its policies caused a lot of confusion. Frequently, when I turned up to work, visitors asked me whether they should pay, whether I had any change for the parking machines, and whether I could help them with where they were going. Not wanting to be too critical of my ex-employer, I have to say that I do not think that Pennine Acute is a shining light when it comes to dealing with car parking for patients and visitors.

[Mr Nuttall]

I do not know when the hon. Lady left the employ of that particular trust, but it seems from its website that it has tried to simplify things by having different coloured signs for different groups—green signs for patients, blue signs for blue badge holders and pink signs for staff. It seems that it is making an effort. I am sure that the hon. Lady knows more than me whether its system is working in practice.

[Liz McInnes]

What the hon. Gentleman said was very telling. He said that he had looked at the website. Not every patient or visitor has access to the website, however. I agree that the system is clear on the website, but it is not clear in reality. When someone turns up with a sick relative or a distressed patient, they do not have time to go through the colour coding. Pennine Acute could improve its signage, but that is not why we are here, or why we are talking about this Bill.

The hon. Gentleman asked how long I had worked at the hospital. I started at North Manchester general in 1987, and I was there when hospital car parking charges were first introduced. I remember the disquiet that was caused to staff, who have always had to pay those charges. Many people do not realise that staff have to pay car parking charges at hospitals.

[Mr Nuttall]

I mentioned it.

[Liz McInnes]

I appreciate that, but it always comes as a surprise to the wider public to hear that staff have to pay to park at their own place of work. I am sure that there would be an uproar if such charges were introduced for our exclusive car park facilities in this place. I know that the staff’s objections to having to pay to park at their place of work have been ignored. We have been protesting about it for many, many years. However, I am not here to talk about staff; I just wanted to make people aware that that practice still goes on. I have always seen it as a tax on coming to work.

We are here to talk about carers. I want to use Pennine Acute as an example. Most recently, it has engaged a private parking company, the income of which comes solely from administering fines to people who have parked incorrectly or who have not paid the right amount of money. The business of this private parking company depends on people contravening parking regulations; it actually wants people to contravene parking regulations, because that is the only way that it gets any income.

When I worked at the hospital, I was a workplace rep for Unite the union. I dealt with a lot of staff who were very, very distressed about the letters they had received from this company, demanding a fine that had to be paid by a certain day, and if they did not pay it by that day, the fine would go up. They were given the opportunity to appeal. If the appeal was not successful, some people found that they had to pay an inflated fine because they had had the temerity to appeal.

With regard to my hon. Friend’s private Member’s Bill, my main concern is about carers. What would happen to them if they were to get one of those bills? At least members of staff, if they are in a trade union, can go to a rep and get some help to deal with the situation. I worry about private parking contractors, because they exist solely to make money out of people. Exempting carers from car parking charges would bring much needed clarity to the matter. It would stop these exploitative companies from making money out of them.

[Julian Knight]

Could the hon. Lady’s local hospital trust not write such a policy into its contract? It would then have discretion over the fines. It would not need to fine carers in a particular situation. That would give them some flexibility, whereas in this scenario, there is no flexibility at all.

[Liz McInnes]

I thank the hon. Gentleman for his intervention, but I am not clear what his point is. He said that the trust could put it into a contract that carers would not be charged—[Interruption.] He means in the contracts of the parking contractor.

[Julian Knight]

indicated assent.

[Liz McInnes]

That would bring us to the issue of how we identify carers, which we have already talked about at length. If we introduce this Bill, it would be clear that carers were exempt. They could approach the hospital trust with evidence that they are in receipt of carer’s allowance. Their registration number would be taken and a badge would be produced with that registration number on, so that there would be no possibility of people transferring permits. They would be valid for only one vehicle. It would take a lot of the stress and worry out of parking at hospital for carers. There has been a lot of talk about how difficult it would be to administer the schemes, but actually it would be fairly simple.

Much is wrong with hospital car parking charges. I applaud the Scottish and Welsh health services for removing the charges. The imposition of car parking charges in England means that staff and others are being treated as a cash cow. While the rate that those charges are put up every single year is way above inflation, hospital staff are suffering from either a pay freeze, or a 1% below-inflation pay rise, which they get only if the Secretary of State deigns to bestow it on them. We really need to look at the whole situation with car parking charges in English hospitals, but at the moment we are considering parking for carers.

At Pennine Acute, there were informal arrangements, to which the hon. Member for Bury North has already referred. Frequent visitors who were in the know could approach the ward manager or departmental manager to ask for help and an exemption from car parking charges if that was available. People need to know that these exemptions exist; that is the problem. This Bill would not cost the NHS a great deal of money, because those in the know are aware that they can ask for exemptions. This Bill is about clarity, so that the exemptions are available to everybody and nobody is kept in the dark about them. That is why we need this Bill.

I fully support the Bill. Points have been made about hospitals introducing car parking fees, but unless a hospital is near a major shopping centre or bang in the middle of a town centre, people will park at a hospital only to visit, attend as a patient or carer or work there, and people should not be penalised for doing any of those things.

I am grateful to my hon. Friend the Member for Burnley for introducing this Bill, and I hope that she is successful in removing charges for carers and bringing much needed clarity to what is a very confused situation. Legislation is long overdue. Hopefully, following the introduction of this Bill, we will look at charges for others—patients, visitors and staff. If it is good enough for Scotland and Wales, it is good enough for England. The policy would be very well received in Heywood and Middleton as well as across the country.

Cities and Local Government Devolution [Lords] Bill

Liz McInnes Excerpts

Wednesday 21st October 2015 Commons Chamber

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

It is a pleasure to serve under your chairmanship, Mrs Main. I rise to make a few brief remarks in support of this clause and the Government amendments. Clearly, the direction of travel that is outlined is desirable in health and care terms. The amendments will put in place clear safeguards to deal with national regulatory structures, which are there to protect patients and to ensure that the quality of care is universally high throughout the whole country.

The importance of devolving health and care at a local level is something that we have often talked about in this place, but we have sometimes struggled to find the legislative mechanisms to make it happen. These powers will be a desirable step forward in encouraging a more integrated model of health and care. We often talk about how we can move the focus in many parts of our health service towards delivering more services in the community and a more preventative approach to healthcare. Clearly, this Bill is a big step in that direction.

By 2018, we know that there will be 3 million people with three or more long-term health conditions. Many of those people will require support not just from the health service, but from adult social care services, local voluntary and charitable organisations and, in the case of some people with special educational needs, education services. It is vital that we properly link and join up the services that are in place to support these people. Personalised care and mechanisms of support are often found at a local level, which is exactly what this devolution is about.

Other measures have been put in place to integrate better adult health and social care, including the better care fund, which was part of the Care Act 2104. The coalition Government also introduced some strong measures to improve the provision for children with special educational needs. But these measures go further and allow more bespoke and personalised local solutions to be put in place to support people with more complex care needs. Importantly, they also recognise that parts of the country are different in terms of not just their geography, but their cultural make up and their demographics. That is particularly important when we talk about devolving health and care. We know that some city areas have high black and minority ethnic populations with specific healthcare needs. These measures will put us in a much better place to help such areas support those communities, as well as more rural areas, in dealing with the challenges of an ageing population and increasing numbers of people with complex healthcare needs.

This Bill is an important step forward, which builds on many strong measures that have already been put in place over the past few years by both the coalition Government and the previous Labour Government. We all believe in integration and in the need to bring healthcare services closer to the individual and make them more personalised. We know that there is too much duplication in the health service and in adult social care, which costs money. That money should be going to the frontline, but duplication often gets in the way of front-line professionals helping patients. This is a big step forward in allowing local health economies and local areas to put in place the right mechanisms to support the people they look after.

[Liz McInnes (Heywood and Middleton) (Lab)]

First, let me echo the words of the Minister and pay my own tribute to my colleague, Michael Meacher, who sadly died today. I was born and bred in his constituency, so he was my MP for a long number of years. He was greatly respected in the constituency and will be very, very sadly missed.

I wish to start by echoing the words of my hon. Friend the Member for Nottingham North (Mr Allen) who said that we need to get this Bill right. The proposals for health devolution raise a great number of questions, which I hope we will deal with in a constructive manner, as we need positive outcomes. Labour Members are concerned about overlapping areas, coterminosity, and cross-border responsibilities, and they have been highlighted by my hon. Friends the Members for Bassetlaw (John Mann), for Denton and Reddish (Andrew Gwynne), for Hemsworth (Jon Trickett) and for Bristol South (Karin Smyth). We need some clarity about how the devolved responsibilities will work in practice.

Oral Answers to Questions

Liz McInnes Excerpts

Tuesday 13th October 2015 Commons Chamber

[Ben Gummer]

My hon. Friend rightly points out that there are specific challenges in Northern, Eastern and Western Devon and that is precisely why NHS England has instituted the success regime and why it has moved quickly to appoint a programme director and team. I hope that with the engagement that I know he will lead with his colleagues they will come to a resolution that will ensure that the challenges cease.

[Liz McInnes (Heywood and Middleton) (Lab)]

9. What additional financial support he is making available to the NHS to help it deal with winter pressures.

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

17. What additional financial support he is making available to the NHS to help it deal with winter pressures.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Some £400 million in resilience money has been invested in the NHS for this winter. Learning from previous years, we have put this money into the NHS baseline for 2015-16 so that the NHS can plan effectively at an earlier stage.

[Liz McInnes]

I thank the Secretary of State for his response. In my constituency we have an excellent and much-used facility—a walk-in centre in Middleton town centre—which is now threatened with closure. Will he support our campaign to keep it open? Does he agree that its closure would create more A&E attendances and increase winter pressures on our acute services?

[Mr Hunt]

I welcome the question and understand the hon. Lady’s concerns about the changes. She will understand that we do not direct these changes centrally and they are decided locally. One of the things we have to try to do is deal with the confusion a lot of people have at a local level as to what they should do when they have, for instance, a child with fever at the weekends and whether they require a GP, an urgent care centre or an A&E department. I would ask all CCGs to be very careful to make sure they sort out that confusion so NHS patients know exactly what they should do.

NHS Reform

Liz McInnes Excerpts

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

My hon. Friend speaks with great knowledge about health matters, because of her previous job. [Hon. Members: “McKinsey.”] Yes, McKinsey, which does some important work for the NHS. She is absolutely right that we need to be able to discharge into the community on all seven days, and it is important that the primary care and social care systems are part of that change.

[Liz McInnes (Heywood and Middleton) (Lab)]

When does the Secretary of State intend to implement the recommendation of the Royal College of Pathologists and introduce the role of medical examiner, to provide independent scrutiny of deaths? That has been repeatedly delayed, despite the success of five pilot schemes and the fact that it was recommended in the Francis report.

[Mr Hunt]

That is an important recommendation, and the Government support it. We intend to implement it, but there are costs involved, which we are going through as part of the spending review process.

Health and Social Care

Liz McInnes Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Liz McInnes (Heywood and Middleton) (Lab)]

It has been a great pleasure to listen to so many wonderful maiden speeches this afternoon, and it is a particular pleasure to follow my hon. Friends the Members for Coventry North East (Colleen Fletcher) and for Merthyr Tydfil and Rhymney (Gerald Jones), who both gave wonderful guided tours of their constituencies. It is a pleasure to welcome them to the House. I almost feel like I am making a maiden speech myself. Mine was a bit of a solitary affair as I was elected in a by-election in October last year, and it is quite nice to feel the solidarity and camaraderie coming from the new Members, who are all supporting each other.

Before I was elected to this House, I spent over 30 years employed as a biochemist in the NHS and I want to talk in particular about the parts of the Queen’s Speech that referred to seven-day working in the NHS. I am concerned about the push towards seven-day working because I feel the impression is being given that the NHS does not currently operate on a seven-day-a-week basis.

Ever since I was first employed in the NHS, the various pathology departments I have worked in have never, ever closed. One of my colleagues used to joke that if he had his time over again, he would have chosen a job somewhere that closed every now and then. We always provided an emergency service at evenings and weekends via an on-call system and latterly, as the workload became more and more demanding, via a shift system. Not everyone took part in these rotas as it was deemed that some jobs had to be done during office hours and allowances were always made for staff with carer’s commitments and family responsibilities. Staff pay for working unsocial hours in the NHS has taken a hit over the past few years, with staff now providing an around-the-clock service for far less remuneration than previously, and I worry that the current push towards so-called seven-day working is merely an attempt to normalise out-of-hours working in order to reduce further unsocial hours payments to NHS staff.

I was very concerned on visiting an NHS lab recently to be informed that management were attempting to get everyone in the lab to work shifts regardless of whether they wanted to or not, or indeed whether their commitments outside of work allowed them to. I worry that the push towards seven-day working is creating a working environment where staff feel bullied into changing their contractual hours because of a perception that seven-day working is now the norm. The fact is that full seven-day working in the NHS will be achieved only by investment in the service. Recognition has to be given that staff working at weekends and on bank holidays are giving up time that would otherwise be spent with their families, and that staff working at night are putting their own health at considerable risk. Sleep disorders, fatigue, gastrointestinal problems, stress and psychological issues commonly affect night workers. All attempts to normalise seven-day-a-week, round-the-clock working should be resisted. Such a service does not come without a price.

Another issue that is causing great concern in my constituency is the provision of health visitors, nursery nurses and school nurses. Health visitors and nursery and school nurses in my constituency are retiring faster than they can be replaced. The service they provide is under a great deal of stress owing to an ever-increasing workload. They perform a vital role in child health, safeguarding and protection, yet the service is struggling, with only 16 school nurses for 42,000 children in the borough. The staff are also concerned that their services might go out to tender, and that they could be taken over by the likes of Virgin Health. Those staff are not being listened to, despite assurances that whistleblowers and staff will be protected and listened to. They have raised these issues with the management, but the management are in denial, saying that there are no problems with the service and accusing staff of negativity if they raise concerns.

Just recently, I received a consultation paper on the child and adolescent mental health service in the borough. It contained plans to reduce demand on the CAMHS service by working more closely with professionals who work with children, and yes, school nurses, nursery nurses and health visitors would be among them. The CAMHS service is the cause of many complaints among my constituents. Common issues include the fact that

“you have to fight just to get referred”,

that

“waiting times are still at 10 to 12 months” ,

and that

“when you get there they are great but the moment you have a diagnosis you are discharged with no other support because they are so busy.”

Funding for the CAMHS service has been reduced under this Government, and a combination of less resources and greater demand has led to the service raising the threshold for access, with initiatives such as the one I have just mentioned, in which one hard-pressed service relies on another hard-pressed service to act as a gatekeeper. None of this is sustainable. Health visitor numbers cannot be maintained with so many leaving because of stress. The average child has 12 minutes of school nursing a year, and parents report that their children cannot access child and adolescent mental health services until their situation becomes critical. I want to ask the Secretary of State what his vision is for the future of health visiting, school nursing and children’s mental health services. These services require investment, the staff need to be listened to, and our children need to be protected.

Barts Health NHS Trust

Liz McInnes Excerpts

Thursday 19th March 2015 Commons Chamber

[Jane Ellison]

I believe we may well be addressing that issue in an Adjournment debate next week. There will be a chance to discuss it in more detail then.

[Liz McInnes (Heywood and Middleton) (Lab)]

Like my hon. Friend the Member for Easington (Grahame M. Morris), I am not from London, but I do feel qualified to speak on this subject. The issues that have been raised about staff morale and the “down banding” of nurses are all too familiar to me. Until October last year I worked for the NHS—I worked for the NHS for more than 30 years—and what is going on at Barts is very similar to what was going on in the trust in the north-west where I worked. Again, it was a large trust, having been formed by the merger of four hospitals. It is an unworkable plan. As my hon. Friend said, we warned about what was going to happen with the Health and Social Care Bill, and it is depressing to see all this come to fruition. The cost of agency staff, which has been referred to—

[Mr Speaker]

Order. May I exhort the hon. Lady to come to a question? I know she has provided her diagnosis, and we are grateful to her for that, but what we need is a question.

[Liz McInnes]

My question is regarding the trade unions and the welfare of staff. Staff morale is at an all-time low in the NHS, and trade unions need to be involved in any special measures that are taken in this trust.

[Jane Ellison]

The CQC’s inspection report does identify some issues of concern to do with staff morale and bullying. As I said to the hon. Member for Easington (Grahame M. Morris) a moment ago, the issues need to be addressed. We want a culture in which all staff can speak out about poor patient care and feel supported in doing so. That is exactly what we have put in place over recent years.

Maternity Services (Morecambe Bay)

Liz McInnes Excerpts

Tuesday 3rd March 2015 Commons Chamber

[Mr Hunt]

Dr Mike Durkin will be delighted that he has been promoted and given a knighthood for his wonderful work on patient safety, but it has not happened yet, even though he certainly deserves it. I thank my hon. Friend for his understanding of the complexity of these issues and the importance of the need for culture change. The work of his Committee has not been to scratch around the surface; it has tried to think hard about the solution. He is absolutely right that we need to end regulatory confusion. We now have a strong CQC, which is doing incredible inspections and is trusted across the system. However, we need a system in which people can get independent external advice quickly, which is why he was right to alert me to the potential of an air accidents investigation branch equivalent. I hope that is something that could be helpful for the ombudsman as well.

[Liz McInnes (Heywood and Middleton) (Lab)]

I am pleased that the Secretary of State has declared his intention to implement the medical examination review. The president of the Royal College of Pathologists, Dr Suzy Lishman, has said that introducing such a system would

“improve patient care whilst reducing harm and saving money”.

She went on:

“If bereaved relatives get the answers that they need around the time of death, if all their questions are answered then, then they don’t feel the need to sue the NHS to get the answers they deserve.”

She has also said that it is “incomprehensible” that the recommended changes have not been implemented. Will the Secretary of State explain why there has been so much delay? From his answer to a previous question, I understand that he is not able to commit to implementing the reforms during the time of this Government.

[Mr Hunt]

With the greatest respect, I say to the hon. Lady that if she is suggesting that we have done nothing on this important issue over the last few years, nothing could be further from the truth. We have been trialling the right system; we think the trials have worked; and we want to make sure that we implement this in a way that is consistent with the many other things we are doing to improve patient safety, including proper case-note reviews of deaths in order to understand the level of avoidable hospital deaths and what we can do to bring the rates down. This is a priority for the Government, and we remain wholly committed to it.