Oral Answers to Questions

Maria Caulfield Excerpts

Tuesday 5th December 2023 Commons Chamber

[Michael Fabricant (Lichfield) (Con)]

2. What recent steps she has taken to help prepare for a future pandemic.

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

Lessons from covid-19 have been incorporated into our planning for any future pandemics across a range of areas. That includes the need to prepare for infections through all five routes of transmission, and for the health and social care sectors to have flexible capabilities that can adapt to a range of health threats.

[Michael Fabricant]

My hon. Friend may have heard that news is emerging from China of yet another respiratory disease spreading through that country. What mechanisms are in place to learn from the covid inquiry when it finishes its work, so that if mistakes were made, we do not make them again in the event that, God forbid, we have another pandemic?

[Maria Caulfield]

First, early indications show that the respiratory illnesses in China are likely to be due to increasing levels of endemic infection. These are normal infections but at a higher level.

Secondly, we are not waiting for the covid inquiry before we implement lessons learned. One of the key changes we have already made is the introduction of the UK Health Security Agency, which carries out surveillance on both national and international threats. A good example of its work is last year’s strep A outbreak, which it managed and contained very well. This year, the identification of a new covid variant—not a variant of concern—meant we brought forward our autumn vaccination roll-out.

[Jim Shannon (Strangford) (DUP)]

For all of us who lost loved ones, covid-19 is still very raw. I have been following the covid inquiry, and two recommendations have so far come forward. The first is that the lockdown should have been earlier, and the second is that those with covid should not have been sent to care homes—covid went through care homes and cast death everywhere. Has the Minister taken those two lessons on board?

[Maria Caulfield]

I know the hon. Gentleman had a personal loss to covid, and he is absolutely right to highlight those lessons learned. We are learning lessons, but each pandemic or increase in infection is different. It may have been appropriate to have lockdowns for covid-19, but lockdowns may not be appropriate for other infections, such as strep A or other respiratory illnesses. We set up the UKHSA to provide expert advice. We are learning lessons from the covid inquiry, and we are already taking action.

[Wendy Chamberlain (North East Fife) (LD)]

3. What progress her Department has made on discharging patients from hospitals and moving them into social care.

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[Feryal Clark (Enfield North) (Lab)]

10. What steps she is taking to improve maternity services.

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

Since 2021, we have invested an additional £165 million a year to improve maternity neonatal care; next year, that figure will rise to £186 million. That investment is leading to progress on outcomes: stillbirths have reduced by 23%, and neonatal mortality rates are down by 30%.

[Feryal Clark]

Women continue to be failed by maternity services across England, as has been highlighted by a string of scandals including East Kent, Nottingham and Morecambe Bay. The Care Quality Commission’s maternity inspections over the past year downgraded many maternity units, branding two thirds of them as dangerously substandard and highlighting shortages of staff, among other problems. What additional steps is the Minister taking to ensure that a woman can go into maternity services knowing that she and her baby will come out alive, and can she tell us whether the recommendations of the Kirkup and Ockenden reviews have been fully implemented?

[Maria Caulfield]

The hon. Lady has touched on three inquiries. The Ockenden inquiry covered the period from 2000 to 2019, the Kirkup review covered the period from 2009 to 2020 and the Morecambe Bay inquiry covered the period from 2004 to 2013, so the Labour Government were also responsible for parts of all those periods.

We are introducing radical changes. We are increasing the number of midwives, which is up 14% since 2010, and the number of midwifery training places has increased by 3,650. We have introduced the maternity disparities taskforce to improve outcomes for those women who face the poorest outcomes, and have also introduced a maternity support programme for those trusts that do badly in CQC inspections—32 trusts are going through that improvement programme right now. Those are some of the things we are doing to improve maternity services.

[Theo Clarke (Stafford) (Con)]

As chair of the all-party parliamentary group for birth trauma, I recently commissioned a survey of mums across the UK via Mumsnet on this issue. I was shocked to discover that one in five mothers was not being offered a six-week GP check post-birth. That means that many women with physical injuries or mental health problems are unfortunately not being diagnosed or offered support, which is very troubling. Will my hon. Friend include birth trauma in the future update to the women’s health strategy, and ensure that all mums receive a post-birth six-week check-up with their GP? That check-up must include both the physical and mental health of the mum, not just focus on the baby.

[Maria Caulfield]

I pay tribute to my hon. Friend’s work in this place. She will be pleased to know that we are rolling out perinatal pelvic health services in every part of England, which should be in place by the end of March next year. In addition, we are rolling out obstetric anal sphincter injury bundles, which my hon. Friend raised in her debate on birth trauma; those have the potential to reduce the number of tears by 20%. She is absolutely right to be driving this issue forward. It will be covered in the women’s health strategy, but we are not waiting for the second year: we are already making progress in this place.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

The Care Quality Commission now says that almost two thirds of England’s maternity services are rated inadequate or requiring improvement in safety, up from 55% last year. The Government have been told time and time again to recruit more midwives, and to value midwives so that they do not want to leave the profession in the first place. As a result of ministerial failure, mothers—especially those from black and ethnic minority groups—do not get the safe, good-quality maternity care that they deserve. What is the Minister’s plan to properly improve maternity care?

[Maria Caulfield]

The hon. Lady may not have listened to my first answer. We have increased the number of midwives—it is up 14% since 2010—and increased the number of midwifery training places by 3,650. We have also introduced a maternity support programme that is providing intensive support for the 32 trusts that are going through it. The hon. Lady may want to speak to her ministerial colleagues in Wales, where Labour runs the health service, because Healthcare Inspectorate Wales recently issued an immediate improvement notice to Cardiff and Vale University Health Board for its maternity services.

[Madam Deputy Speaker (Dame Eleanor Laing)]

We will have to go a bit faster.

[Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)]

11. What steps she is taking to improve access to mental health services.

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

We are improving mental health services, transforming them with an extra £2.3 billion a year. We have already seen some improvements in the delivery of those changes from giving mental health services parity of esteem with physical services.

[Lloyd Russell-Moyle]

The Minister will know, because it covers her constituency as well, that the Sussex Partnership NHS Foundation Trust does vital work in mental health, but there simply is not the resource, and I am afraid that parroting about parity of esteem does not tackle the issues. Wait times are 190 days for children and young people in her constituency and mine. I recently spoke to a mother in Peacehaven whose son is waiting for an attention deficit hyperactivity disorder diagnosis. His performance at school is in rapid decline, but because of the wait times he is not eligible for support in school via any education, health and care plan to start to turn things around. What assurances can the Minister give my constituents, and indeed her constituents, that the wait times for mental health will come down and that resources will be given to these partnerships, rather than just empty words?

[Maria Caulfield]

The hon. Member is absolutely right: we know that in Sussex we have higher rates of mental health illness than in many other parts of the country, with a 15% increase in Sussex A&E attendances. He might not be aware of them, but multiple schemes are available in Sussex. Health in Mind is offering psychological support to those suffering stress and anxiety, which can be self-referred. We have the Sussex mental health crisis line, now open 24/7, which is accessed via the 111 service. We have mental health professionals rolling out the blue light triage service in Sussex, and we have the Brighton and Hove mental health rapid response service, open 24/7, to which anyone can refer themselves urgently. Perhaps if he looks at some of the services provided locally, he will be able to reassure his constituents.

[James Morris (Halesowen and Rowley Regis) (Con)]

The Minister mentioned the importance of parity of esteem, and she is quite right, but it is disappointing that the Government had a manifesto commitment in 2017 and 2019 to reform the Mental Health Act 1983, which they have not fulfilled, with no such Bill in the King’s Speech. Would the Minister agree with me that the issues that existed prior to 2017 in relation to the Mental Health Act still exist today with the disproportionate number of black and minority ethnic people being sectioned under that Act, and people with learning disabilities and autism kept in inappropriate settings? Can she give any encouragement to those of us who want to see that reformed, particularly in relation to the appointment of a mental health commissioner to oversee changes to the Act and to advocate for the parity of esteem that she is looking for?

[Maria Caulfield]

It remains our intention to bring forward a mental health Bill when parliamentary time allows. We have the draft Mental Health Bill, which we have put through pre-legislative scrutiny. We are looking at the report from the Joint Committee and will be responding to that shortly.

[Marion Fellows (Motherwell and Wishaw) (SNP)]

12. What recent assessment she has made of the potential impact of increases in the cost of living on mental health.

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

We are acutely aware of the impact that the cost of living has on mental health, which is why this Conservative Government spent over £350 billion during the pandemic on protecting people’s jobs and over £60 billion during the recent cost of living pressures to pay for their energy bills.

[Marion Fellows]

The Centre for Mental Health, the British Psychological Society and others have raised serious concerns about the UK Government’s new back to work plan, warning that the increased threat of applying benefit sanctions or coercing people into jobseeking will be detrimental to claimants struggling with their mental health. Does the Minister share my concern about this, and has she made any representations to her Cabinet colleagues about the mental health impact of these measures?

[Maria Caulfield]

That is the difference between the SNP and the Conservatives: we have aspiration for people, and we absolutely want to support people with mental health problems and illness to get into work. They should have the same opportunities to get into work, and not just to get a job, but to get a good job and get a career. If we look at its website, Mind supports people getting into work, saying that it is not just a source of income, but provides a “sense of identity” and “structure” as well as support, confidence and ambition.

[Sally-Ann Hart (Hastings and Rye) (Con)]

A recent study by Magic Breakfast and the British Nutrition Foundation found that eating a healthy breakfast can improve the nutritional intake of the most vulnerable children, improving their physical and cognitive development and their mental health. Will my hon. Friend work with colleagues in the Department for Education to consider expanding school breakfast provision in order to reduce the health impact of child food insecurity?

[Maria Caulfield]

We want a more cross-Government approach to mental health provision, and that is why in our suicide prevention strategy we are working with multiple Departments. My hon. Friend asks about support for nutrition in schools, and I will certainly raise that with colleagues in the Department for Education to see what more can be done.

[Amy Callaghan (East Dunbartonshire) (SNP)]

I welcome the Secretary of State to her new role. Research by the Mental Health Foundation found that the cost of living crisis has left a third of UK adults feeling anxious, more than a quarter feeling stressed, and almost one in 10 feeling hopeless. What representations has the Minister made to Cabinet colleagues regarding the impact of the cost of living crisis on health outcomes since she took up her post?

[Maria Caulfield]

I have outlined some of the financial support that the Government have given during covid and the cost of living pressures. I also point to schemes that the Treasury has rolled out, such as the Breathing Space programme, which sees enforcement action from creditors halted, and interest frozen for people with problem debt who are experiencing mental health issues, and covers a 60-day period. That is the sort of practical help that this Government are giving to people.

[Madam Deputy Speaker (Dame Eleanor Laing)]

We now move to topical questions. We are running late because questions have been too long, as have answers. I often make this plea. In any case, Members should not be reading their questions—questions are not meant to be read; they are meant to be questions. Can everybody please cut out those bits that say their constituency is beautiful, for example, and just ask a question? We all believe that our constituencies are beautiful, and none more so than mine.

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[Amy Callaghan (East Dunbartonshire) (SNP)]

Brexit broke Britain and it is continuing to wreak havoc on supply chains. The shortage of ADHD medication is now set to drag on into next spring. The shortage has seen 70% of patients forced to ration their supply of ADHD drugs, with 62% reporting an increase in suicidal thoughts. What steps is the Minister taking to ensure that supplies of these vital medications are reaching pharmacies across the UK?

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

The shortage of ADHD medication is a global issue; it is not Brexit-related. We are hoping to have some positive news over the coming weeks.

[Dr Luke Evans (Bosworth) (Con)]

T9. My local practice, on Heath Lane in Earl Shilton, released its “did not attend” figures. Between 20 November and 24 November, 69 appointments—including 36 GP appointments and 28 nursing appointments—were missed. That was 12 hours lost in five days. If that is happening up and down Hinckley and Bosworth and across the country, that is thousands of hours being missed. I know that the Government are keen to see more on data, so will they consider statementing patients on how much missed appointments cost, because clinically that would make a big difference to the awareness of what people are cashing out on?

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[Liz Twist (Blaydon) (Lab)]

T3. As we know, there are strong links between financial difficulties, mental health and suicide. The poorest 10% are twice as likely to die from suicide than the wealthiest 10%. With so many people struggling to make ends meet, how is the Minister going to ensure that those seeking financial support get access to mental health support, and that those seeking mental health support get access to help with their finances?

[Maria Caulfield]

May I pay tribute to the hon. Lady for her work on the all-party parliamentary group on suicide and self-harm prevention? She knows that financial difficulty is a priority area in the suicide prevention strategy, because we know it is a high risk factor. That is why suicide is now everyone’s business—not just the Department of Health and Social Care, but our colleagues at the Department for Work and Pensions, His Majesty’s Revenue and Customs and all Government Departments. Anyone who has financial stress and pressure will be given support to reduce their risk of suicide.

[Miriam Cates (Penistone and Stocksbridge) (Con)]

My constituent Dan Archer runs the highly successful Visiting Angels care agency, which has an annual staff turnover rate of just 13%, compared with an industry average of 60%. The secret to his success is very straightforward: paying decent wages, investing in training, valuing staff and prioritising client satisfaction. As a consequence, an enormous amount of money is saved on recruitment and invested into training and retention instead. Would the Minister meet my constituent to learn more about the success of Visiting Angels and how it can be shared more widely to help solve the shortage of workers in the care sector?

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[Siobhan Baillie (Stroud) (Con)]

Stroud Maternity Hospital is doing a great job, but the post-natal beds are still not open. We have been chasing a ministerial meeting about that for some time. Will my hon. Friend meet me and the Gloucestershire NHS scrutiny chair, Andrew Gravells, to discuss the issue? We think that we need some help with the Care Quality Commission.

[Maria Caulfield]

I am happy to meet my hon. Friend to discuss that specific issue. We are doing a piece of work on a capital survey of all maternity units as well as working with the CQC on how capital infrastructure—beds and so forth—are impacting on maternity performance.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

T10. Attention deficit hyperactivity disorder medications are essential to many people. In response to my written question last month, the Department outlined “disruptions to the supply”, which are expected to “resolve in early 2024”. How have the Government allowed that to happen? What plans does the Department have to prevent a similar situation from occurring in the future?

[Maria Caulfield]

As I said in an earlier response, there is a global shortage of ADHD medication. As we set out in our response to her written question, we expect that to be resolved shortly.

[Jeremy Quin (Horsham) (Con)]

Lobular breast cancer treatment must be improved. Will the Minister meet my constituent and me to discuss how?

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[Jonathan Gullis (Stoke-on-Trent North) (Con)]

In response to a written question that I submitted, I was told that the Department of Health and Social Care holds no central data for diagnosis and treatment of those with eating disorders and has no idea how many mental health nurse appointments are available in GP surgeries, despite all the funding. Do Ministers agree that that is a disgrace?

[Maria Caulfield]

NHS England holds some of that data. Central data is one of the things that we are introducing right now to improve our access to data. It makes it difficult to plan services when we do not have that dataset, but we are working to resolve that as quickly as we can.

[Sarah Dyke (Somerton and Frome) (LD)]

Farmers face many serious mental health challenges, including the financial precipice that this Government have led them to. According to the Farm Safety Foundation, 95% of young farmers in this country identify poor mental health as their biggest hidden challenge. Will the Minister meet me and the Secretary of State for Environment, Food and Rural Affairs to discuss how we can best support farmers and farm workers to develop robust mental health strategies?

[Maria Caulfield]

I attended the National Farmers Union session in Westminster just before the launch of our suicide prevention strategy. We recognise that isolation and loneliness in rural communities is an issue. I am happy to meet any hon. Members who wish to discuss how we can better support farmers, improve their mental health and reduce suicide rates.

[Richard Fuller (North East Bedfordshire) (Con)]

Will the primary care Minister join me in congratulating the Conservative Mayor of Bedford borough for proposing council money to invest in primary care facilities in Great Barford, Wootton, Wixams and Kempston? Will she condemn Labour and Liberal Democrat councils for voting it down?