Covid-19

Liz Twist Excerpts

Tuesday 1st September 2020 Commons Chamber

[Matt Hancock]

Yes I do, and I put everything I possibly have into driving it as fast as possible, subject to it working effectively.

[Liz Twist (Blaydon) (Lab)]

Today’s Office for National Statistics suicide statistics show that middle-aged men remain at the highest risk of suicide. It is well established that recessions can lead to increases in suicides, but that is not inevitable. What will the Secretary of State do to ensure that suicide prevention is a Government priority and that this group of people is supported through the recession caused by the covid-19 pandemic?

[Matt Hancock]

The hon. Lady is quite right to raise this issue. It is good to see the figures showing that suicide rates have fallen, but we absolutely must and will remain vigilant.

Covid-19: R Rate and Lockdown Measures

Liz Twist Excerpts

Monday 8th June 2020 Commons Chamber

[Liz Twist (Blaydon) (Lab)]

Following on nicely from that, what local resources and funding will be put in place for local authorities to deal with local lockdowns where they are needed?

[Matt Hancock]

We have already allocated £300 million for precisely that task. Making sure that local authorities are properly funded for their important role in local action is of course an important part of the task.

Covid-19 Update

Liz Twist Excerpts

Tuesday 24th March 2020 Commons Chamber

[Matt Hancock]

I will say three things in response to my right hon. Friend’s questions. On special schools, one of the carve-outs in the closure of schools was keeping open schools for those who are vulnerable, including those with special educational needs. The Bill includes a power to enable us to move from that position, but we do not propose to exercise it unless absolutely necessary. The position therefore is that if someone wishes to send their child to a special school, that is fine. It was one of the specific carve-outs. In the same way, if a key worker needs to send their child to school and cannot look after them at home, schools are available.

My right hon. Friend asked about care. I want to make it clear that for people who are volunteering in response to covid-19 and those who are caring, even if their responsibilities are unpaid or informal, they are okay to do that and should do that. They should stay more than 2 metres away from others wherever possible, but that has to be a practical instruction, because of course we need to care for people. As I said in the statement, travel allows for caring, and I want to make it clear that volunteering in the response to covid-19 is a legitimate reason to travel. For example, the increasing numbers of volunteers in the NHS are important. Although it is not paid work, it is work in the national effort to respond to covid-19.

My third point is that the Patient Safety, Suicide Prevention and Mental Health Minister is sitting next to me and close to me, because she has recovered and all the evidence shows that people cannot catch covid-19 twice, at least not in quick succession. I welcome her back to her place.

[Liz Twist (Blaydon) (Lab)]

Following on the volunteering theme, I know that the Government have already made arrangements for schools and given advice that volunteers may still go in for certain purposes. Will the Secretary of State expand that to cover organisations such as Samaritans, which uses volunteers to travel to call rooms? Will he make it clear that it is acceptable for volunteers to do that?

Alcohol Harm

Liz Twist Excerpts

Tuesday 17th March 2020 Westminster Hall

[Liz Twist (Blaydon) (Lab)]

It is a pleasure to speak in this debate. I wanted to take part in it because alcohol harm has been a live issue in Gateshead and the rest of the north-east for a long while. Across Gateshead, which covers my community, the admission rate for alcohol-related conditions in 2010-11 was 817 per 100,000, compared with 643 for England as a whole. However, when we look at 2018-19, the latest year for which we have figures, we see that the rate had increased by 28% compared with an all-England increase of 3%. Admission rates for alcohol-related conditions now stand at 1,045 per 100,000 for Gateshead, compared with 664 per 100,000 across England.

I will talk specifically about minimum unit pricing, as other colleagues have done. Sheffield University research shows that if there was a minimum unit price of 50p per unit, there could be 8,000 fewer deaths, 14,000 fewer hospital admissions and 21,000 fewer crimes related to alcohol consumption every year. The impact of minimum unit pricing would be greatest in the most deprived areas, even though—this point is really important—people in those communities do not necessarily consume larger amounts of alcohol. Nevertheless, nine out of 10 alcohol-related deaths in those areas could be prevented.

I will also say a little about the impact of pubs, because most Members will have been lobbied very strongly by constituents, as I have been, as part of the Long Live the Local campaign, especially in the run-up to the Budget. I agree with the idea behind Long Live the Local. In fact, I will declare an interest, as a community shareholder in the community pub in the village where I live, Ye Olde Cross; we won an award recently for saving our pub. However, having made that plug, pubs seriously have an important role to play in the community.

Evidence already mentioned by the hon. Member for Congleton (Fiona Bruce) shows that minimum unit pricing would have little impact on pubs, as the minimum unit price is aimed at the strongest and the cheapest alcohol. Across the UK as a whole and more specifically across the north-east of England, where my constituency is, 48% of pub managers support minimum unit pricing, because they are competing with cheap, shop-bought alcohol that is consumed at home or while people are out and about.

I want to be clear that to resolve this issue, we should not simply point the finger at individuals; this is a public health issue and it must be tackled as such. For many people, it is linked to poverty, poor social conditions and lack of opportunity, so we need to take a holistic approach to resolving it, and minimum unit pricing is one element of that approach.

I am sure that the Minister knows what I am about to say—we need to restore public health funding. We also need to ensure that public health directors know what their funding is, so that they can provide the appropriate services, as a matter of urgency.

As other Members have said, minimum unit pricing must be part of a wider strategy. I urge the Minister to consider minimum unit pricing as an important part of that strategy along with marketing, which makes alcohol more attractive.

I thank colleagues at Balance North East for their research and for working with me on this issue. I also want to say that this is not about completely stopping people drinking; that is a personal choice. It is about ensuring that the odds are not stacked against people who may find it difficult not to drink to excess.

Coronavirus

Liz Twist Excerpts

Wednesday 11th March 2020 Commons Chamber

[Matt Hancock]

I am grateful for the constructive tone in which the hon. Gentleman asked the questions. This is an example of the House working well, because he and I have sometimes had cross words across this Chamber, but he has asked these two questions quite rightly. The advice given on 111 has to be dependent on the circumstances presented to the clinician giving that advice on the other end of the phone. It is really important that I do not fetter their discretion, but if he comes to me with details of the individual case and wants me to double-check that his constituent got the right advice, I am happy to do so.

On the second point, the deputy chief medical officer had a discussion with the Prime Minister today that was videoed and put on Facebook, and in that she was clear on this question about masks. There is not an advantage in wearing a mask if you are healthy—that is the advice from the medics here—but there is an advantage in respect of keeping others safe if someone who is ill wears a mask. There are also examples of when medical staff will need to wear the right type of mask to keep them safe. But the general advice is: don’t wear a mask unless you are advised to by PHE; or if you are ill, it is perfectly reasonable to wear a mask to stop infecting others—that is an act of generosity.

[Liz Twist (Blaydon) (Lab)]

First, I thank Mr Speaker, his team and the House authorities for ensuring that this statement is signed. A concern has been raised by Action on Hearing Loss and others about the lack of information in British sign language.

This afternoon, my office was contacted by a constituent whose mother is in a care home that has been closed to visitors for what is described as “the foreseeable future”. Will guidance be issued to residential care homes to ensure that the proper arrangements are made for access to residents?

Health Inequalities

Liz Twist Excerpts

Wednesday 4th March 2020 Commons Chamber

[Liz Twist (Blaydon) (Lab)]

Madam Deputy Speaker:

“Good health is an indication that a society is thriving and that economic and social and cultural features of a society are working in the best interests of the population”—

not my words, but those of Michael Marmot last week. It was hard to hear his conclusions on health equity 10 years on from his 2010 report, especially for those of us in the north-east, where we have seen the biggest declines.

In the Metropolitan Borough of Gateshead, which includes my constituency, the gap in life expectancy between the most deprived and least deprived areas has increased: in 2010-12 it was 8.6 years for men, but for 2016-18 it was 12 years; for women, the gap has increased from 8.8 years to 11.2 years. The gap in healthy life expectancy is even more stark: between 2009-11 and 2016-18, the gap in healthy life expectancy for women in Gateshead increased from 4.6 years to 6.2 years. Healthy life expectancy is a significant issue because it creates more pressure as people need support from the NHS and social care.

The Minister said earlier that local authorities need to and can take control of this issue; Gateshead has been doing so, as recognised by Michael Marmot. The North East Child Poverty Commission estimates that 209,272 children throughout the north-east are growing up in poverty. That is 6,224 children just in my constituency of Blaydon, or nine children in a class of 30, living in poverty. There is growing evidence that growing up in poverty has a devastating effect on children’s physical and mental wellbeing.

This morning, I attended the launch of the Royal College of Paediatrics and Child Health report on the state of child health in 2020. During the speeches, I was struck by the president of the college saying that it was too late for him to change his life expectancy—unless he takes up smoking and drinking, which he is not going to do—so he is focusing on the need to act for children. I was also struck by one of the things that the college recommended, which was for the Government to restore the money from the £1 billion real-terms cut to the public health grant for local authorities. It also recommended that funding should increase at the same rate as that for the NHS and be allocated based on population health need.

I would have liked to talk about smoking and alcohol, but time does not permit.

Medicines and Medical Devices Bill

Liz Twist Excerpts

2nd reading & 2nd reading: House of Commons & Money resolution & Money resolution: House of Commons & Programme motion & Programme motion: House of Commons & Ways and Means resolution & Ways and Means resolution: House of Commons
Monday 2nd March 2020 Commons Chamber

[Liz Twist (Blaydon) (Lab)]

The Bill is, of course, necessary to ensure that, in the absence of the European regulations under which we operate until the end of the implementation period, there are effective ways to regulate medicines and medical devices. Even under the current regulatory arrangements we have seen some patients face real difficulties, so it is vital that we get this right, as others have said.

The Minister will be aware that I and many hon. Members across the House have been working with the National Society for Phenylketonuria, or PKU, through the all-party group, to ensure that people with PKU have access to Kuvan, a drug widely available in many other countries. It feels like that has been a pretty hard slog at times, and we have not got there yet. I pay tribute to the NSPKU and, in particular, to Kate Learoyd and Caroline Graham, who have done such a lot of work to get the all-party group established and keep it very lively.

How much more difficult must it be for those people living with PKU—children and adults—to know that there is a drug that would help many of them, but to find that it is not available, than it is for us to see that situation for our constituents? In introducing the debate, the Secretary of State made a great deal of our new powers to act under these arrangements, and I hope very much that that means that Kuvan will become available very quickly. More broadly, I ask the Minister what this Bill will mean for patients with PKU who are hoping to have that drug made available, and how it will affect new therapies and drugs that are in development to treat PKU. How will they be licensed and made available?

Many rare diseases require a large pool of patients to have effective clinical trials of new treatments, and again I ask the Minister if she can say how she will ensure that UK patients can take part in those trials and benefit from innovative treatments. This will be important to the community of patients with rare diseases, not only those with PKU, and I know that there will be great anxiety about the issue of translating EU regulation into UK law and making sure that issues of access, safety and clinical trials are fully covered and regulated. UK patients with rare diseases must not be disadvantaged by separate licensing and trial arrangements, and I ask the Minister to comment on that.

Secondly, this legislation clearly impacts on the role of the MHRA. At this point, I want to mention the great work of Emma Murphy and Janet Williams, who have worked so hard on the issue of fetal valproate spectrum disorder, to which my hon. Friend the Member for Leicester South (Jonathan Ashworth) referred. They have found that, despite the devastating impact arising from women with epilepsy being prescribed the drug valproate during pregnancy and despite these problems being known about among the medical profession for many years, that drug is still being prescribed, sometimes in unmarked boxes, and is still causing damage to babies whose mothers have taken the drug. I hope that this new system will ensure that the regulations are strengthened to ensure that that cannot happen in any case in the future—the will is there to do it. This is happening even after advice to doctors and pharmacists had already been given as a result of the fetal valproate syndrome campaign, so we need action to resolve that straightaway.

[Dr Whitford]

I totally agree with the hon. Lady about the concerns and, we hope, the opportunity to ensure that any pack of sodium valproate that is dispensed carries the information. Does she share my concerns at the talk of having digital information, as many people are digitally excluded? Having actively to seek information about a drug is perhaps an additional barrier. We should be making this easier, simplifying the leaflets that are in with drugs, perhaps by having more infographics, to allow people with poor English or limited understanding to recognise what they should be doing around their medication.

[Liz Twist]

I thank the hon. Lady for her intervention, and I agree that there is a concern about that. All forms of communication are great, and digital, as an extra, is good, but it must not exclude people who do not have access to computers or the internet. It certainly must not replace those paper warnings on boxes of tablets—we need to strengthen that bit as well.

I would like to see a strengthening of this legislation to make sure that what I have described could never happen again. I would also like to see effective data sharing, so that issues such as this were identified and acted upon quickly. Data sharing with the EU will continue to be important, so I ask the Minister, how will such data be shared with EU countries to ensure that we share those experiences and warnings?

Finally, I am concerned at the use of Henry VIII powers to create pharmacy hubs. There is already a concern that some community pharmacies face challenges from prescription-by-post services, at the same time as we are encouraging people to seek advice from their local pharmacist first. It is really important that local pharmacies are not pushed out of communities as a result of these measures, because they are really valued by the people who use them. Will the Minister tell me how she will ensure that that does not happen as a result of the powers to create pharmacy hubs?

Social Care

Liz Twist Excerpts

Tuesday 25th February 2020 Commons Chamber

[Liz Twist (Blaydon) (Lab)]

As I was preparing for this debate, I looked at last year’s debate and, as other hon. Members have said, it was like we have not moved on at all. We are repeating the same arguments, and nothing has really changed. What has changed, however, is that we are seeing increased demand for social care, whether domiciliary or residential, but local authorities’ ability to deliver that support is decreasing because of financial pressures.

Demand is continuing to rise. Age UK says that 1.5 million people aged 65 or over have an unmet social care need and believes that that could rise to 2.1 million by 2030 if the current approach continues. Last year, over half of the 1.32 million new requests for social care resulted in no services being provided. In my constituency, Age UK tells me that 3,012 older people have unmet care needs, and that 2,517 older people are providing the care that family members require. Of course, we must also recognise that thousands of unpaid care workers are providing support to people in their homes, and we must never forget that. I salute them for carrying out that essential work.

I will reiterate some of the points covered in the previous debate, because they remain central to this debate on social care. We need more money. We do not need the drip feed of a 2% increase in council tax, which in constituencies with a low council tax base, such as mine, will not produce anything near the money we need, compounding inequality and injustice. We need a substantial increase, and Age UK estimates that an increase of £8 billion is required over the next two years to stabilise the current system while we look at what will be provided in the future.

We need to look at the market for social care providers. The market is fragmented at the moment in both residential and domiciliary care, and most authorities have seen providers fail in both areas, meaning that they need to step in as an emergency measure to ensure that people get the help they need. We cannot continue with a market based substantially on price competition, because local authorities are forced to look for the lowest bids. We need quality services that deliver the things that people require and deserve. I would like to see more directly provided social care services, because that gives us control.

We must now develop a workforce strategy for social care. We have talked about that a lot in relation to the NHS plan and the future workforce strategy, but we need to look at it here, too. The social care workforce is predominantly female. They provide the most personal and intimate care to the people we love, and we must recognise the value of their work. They need proper pay. They need professional registration, which people working in the sector are considering. They need improved training and development if we are to recruit and retain the staff we need. We must put an end to carers travelling in their own time, to zero-hours contracts, and to 15-minute visits, which all of us would agree are completely outrageous.

[Alex Cunningham]

My hon. Friend mentioned the very personal nature of the care provided by prepared carers, but young carers also do this. They allocate medicines, and they even take their parents to the toilet or wash them. Does she agree that so much more needs to be done to recognise the role of young carers and to give them even greater support?

[Liz Twist]

I certainly agree that we must recognise the work of young carers, who do a tremendous job. We place huge pressure on them, and we thank them for their work. We must look after them, too.

We need a workforce strategy, and there is much more I could say. Others have already touched on the high cost of care for those with dementia, as opposed to a physical illness, and we need to do something in both the short term and the long term. We need a long-term, thought-through plan for providing social care to all those who need it.

We need a plan for social care that supports people when they need it and that cares for people when they need it. It should not just look after them mechanically; it should care for them. The Prime Minister said during the election that he has a plan. Well, let us see it and debate it, because we all know this action is long overdue.

Oral Answers to Questions

Liz Twist Excerpts

Tuesday 28th January 2020 Commons Chamber

[Matt Hancock]

The hon. Gentleman makes an incredibly important point. General practice, where 90% of all NHS appointments take place, needs to reach every part of this country, including his beautiful constituency, which is, as he says, very sparse. Of course we need to ensure that the practices there are sustainable, and again this is an area in which technology can be of particular help. There is great enthusiasm for using technology so that the travelling times of patients and sometimes of GPs can be reduced.

[Liz Twist (Blaydon) (Lab)]

2. What assessment he has made of trends in the level of unmet demand for adult social care.

[Marsha De Cordova (Battersea) (Lab)]

7. What assessment he has made of trends in the level of unmet demand for adult social care.

[The Minister for Care (Caroline Dinenage)]

The Government have enshrined in legislation through the Care Act 2014 a council’s statutory duty to meet eligible needs for adult social care. We have given councils access to up to £1.5 billion more dedicated funding for social care in 2020-21 to help them to meet this requirement.

[Liz Twist]

Figures from Age UK show that 1.5 million people aged 65 and over have an unmet social care need, and Age UK estimates that this figure will rise to 2.1 million by 2030 if we carry on as we are. In my constituency, that equates to 3,012 older people with unmet needs and 2,517 older people providing unpaid care. Those are real people who are not getting the help they need. The Prime Minister said last summer that he had a plan to “fix” social care. Where is it?

[Caroline Dinenage]

As I have explained, the Care Act sets out the requirement that entitles individuals to a care needs assessment and sets a minimum national threshold at which care should be delivered. We have backed councils up by giving them access to £1.5 billion in additional funding in the next financial year. In the hon. Member’s constituency, that will equate to an additional £5.1 million from the new social care grant. This is something that the Government take very seriously.

Health and Social Care

Liz Twist Excerpts

Thursday 16th January 2020 Commons Chamber

[Matt Hancock]

I will rattle through as fast as I can, Mr Deputy Speaker, but I also want to take as many interventions as I can, if that is okay. [Interruption.] No, okay, no interventions. That is an unusual request from the House, if I may say so. [Laughter.]

Putting social care on a sustainable footing, where everybody is treated with dignity and respect, is one of the biggest challenges we face as a society. The Prime Minister has said that we will bring forward a plan for social care this year. These are complex questions and the point my hon. Friend raises is very important.

The draft legislation on the long-term plan Bill aims to help us to: speed up the delivery of the long-term plan; reduce bureaucracy; and help to harness the potential of genomics and other new technologies. I hope the House will support it.

The third piece of proposed legislation is the medicines and medical devices Bill. We are at an important moment in the life sciences. This country can and will be at the forefront as the NHS gets access to new medicines and new treatments earlier, so patients can benefit from scientific breakthroughs sooner.

[Liz Twist (Blaydon) (Lab)]

During the election campaign the Prime Minister promised a member of the public that the Government would look into the availability of Kuvan. Kuvan has been available for the treatment of PKU for 11 years. Will the Secretary of State commit to ensuring that that drug becomes available?

[Matt Hancock]

I can tell the hon. Lady that since the election I have been working on precisely that. I am very happy to meet her to see whether we can make a breakthrough.

--- Later in debate ---

[Liz Twist (Blaydon) (Lab)]

May I start by congratulating the hon. Member for Sevenoaks (Laura Trott) on an accomplished and thought-provoking speech? I am sure that she will represent her constituents well.

I am very pleased to be able to take part in this important debate on health and social care. Earlier this week, I chaired a breakfast roundtable organised by the Industry and Parliament Trust, bringing together industry representatives, third-sector organisations and parliamentarians to discuss the issue of suicide in the construction industry. As chair of the all-party group on suicide and self-harm prevention in the last Parliament, I am familiar with the statistics on the number of lives lost to suicide and the statistics that show that middle-aged men are particularly at risk. However, even I was shocked to hear that two construction workers each day die by suicide and that twice as many die by suicide as die falling from heights.

A huge amount of work has rightly been done on reducing the physical risks in the construction industry. I am glad that there are now moves by some employers and charities such as Mates in Mind to put the same focus on tackling mental health issues and preventing suicide in the construction workforce. There are issues and problems caused by job and financial insecurity, physical stress, working away from home and loneliness.

I want to speak about the wider issue of suicide prevention. I am glad that the Minister is in her place to hear this. Last year, the number of deaths by suicide in the UK rose significantly—an increase of more than 600 on the previous year. There were 6,507 deaths by suicide in 2018. The statistics show that middle-aged men remain the highest risk group, though rates among young people, too, are rising. This is at a time when there is increased talk of improving mental health services in the NHS plan and a focus on suicide prevention. Clearly, the Government need to be doing more for individual people and at policy and practice level to reduce those figures.

Suicide is a public health issue. It is startling to know, from work done by the University of Manchester in 2018, that two thirds of people who take their own lives are not in touch with mental health services in the year before they die. A way needs to be found of reaching out to these people. We know from work by the Samaritans and others that socioeconomic factors are often at the root of the desperation which many people feel. Low incomes, job insecurity, unemployment, housing problems and benefits issues all play their part. Although there is a cross-Government suicide prevention work plan, what needs to happen is for each Department to take clear actions to make a real difference. I understand that the Department for Work and Pensions, for example, has no concrete actions from the plan, but those of us dealing with constituents on a day-to-day basis will know that that Department has a real impact on people, especially when they are struggling.

Most local authorities do now have suicide prevention plans, but the Government must do more to make sure that those that do not develop them as a matter of urgency, and that those that do, follow up the written plans with action and share experience and best practice. I have to say that reducing public health funding is tying the hands of those local authorities that are translating those plans into actions and real interventions.

Some £57 million has been made available for suicide prevention, but those of us who have tried to track it with our local health services have found it difficult to identify what specific actions that translates into when it is spread so thinly that it is almost invisible in the budget. Local NHS services need to make sure that the gaps in services, which too many people can fall through, are filled in. For example, there must be a way for people who are considered “too suicidal” for talking therapies to be able to access secondary mental healthcare more quickly, and non-clinical services need to be available, too.

I have already mentioned the fact that middle-aged men on low incomes have been the highest risk group for many years. Much more needs to be done to understand what really works to support this group when they are struggling. Research, again by the Samaritans, shows that the poorest men living in the most deprived areas are 10 times more likely to take their own lives than the wealthiest living in more affluent areas. We really need some concrete action to address that.

I wish to speak briefly about self-harm. Levels of self-harm among young people are rising. There is a real stigma around self-harm that stops people seeking help. Most people who self-harm do not go on to take their own life, but there is evidence that many people who do have self-harmed in the past. It is a sign of deep emotional distress and people who self-harm must have access to support to identify why they are feeling so distressed. Plans are needed in that area, too.

In summary, suicide prevention is a public health issue and should be tackled as such. Low-income middle-aged men are at the highest risk of suicide and we need to tackle and identify the causes of that and develop accessible services. Levels of self-harm are increasing and need to be tackled now. The Government need to do much more to address this issue and they need to put more resources into both the NHS and the local authorities to reduce the number of people dying by suicide.