Agenda for Change: NHS Pay Restraint

Debate between Mark Durkan and Nigel Evans

Monday 30th January 2017 Westminster Hall

[Mark Durkan]

I agree with all of the hon. Gentleman’s points; they touch on points made in interventions by other hon. Members. Let us be clear: the long-standing freeze is, in essence, a long-term pay cut in real terms. People are left feeling frustrated and aggrieved by that. People are leaving the profession; they feel they are being driven out—we heard references to the number of people who are switching to agency roles, but many people do not want to do that, and their sense of vocation is being exploited in a way that now probably more than borders on the cynical. A better response is needed.

I have made points particularly on Northern Ireland. On Agenda for Change, we know, as other hon. Members have mentioned, that pay in the lower bands actually falls below living wage standards. One appalling vista—which will bite this year in Northern Ireland, where these adjustments are being made—is that the money for that 1% pay rise will be used to bring people in the lower wage bands up to the living wage. In other words, if the 1% envelope is to be used to cover that, other people will lose out; there will be a trade-off between nurses and health service professionals in different grades, with that 1% being prioritised towards bringing people up to the living wage. Nobody should be asked to endure inadequacy as the price of affording a micro-concession to equality for those who are locked into the lower bands that pay below the living wage. That is going to bite in Northern Ireland this year.

It should not, because as part of the Stormont House agreement and other things, Northern Ireland has a voluntary exit scheme that was meant to reduce the cost of the public service payroll. If that overall voluntary exit scheme saves money on the public service payroll, my party made the point that, rather than those savings being used to pay for a cut in corporation tax in future years, they should be used for restorative pay measures—starting first in the national health service for those staff who have suffered as a result of freezes and who are stuck on inadequate and unfair pay bands under Agenda for Change. Their case could be met because public sector payroll savings are on the way.

Health service staff in Northern Ireland will be asked to manage yet more change. People already work long hours in heavy-demand services, but more structural changes will be made to health services following the Bengoa review and others. If people are being asked to manage all of those changes and keep those services going during those transitions, the one thing they are entitled to is some long overdue consideration of the inadequate pay they have been asked to endure.

[Mr Nigel Evans (in the Chair)]

I call Dr Philippa Whitford.

Suicide Prevention

Debate between Mark Durkan and Nigel Evans

Wednesday 6th February 2013 Commons Chamber

[Mark Durkan (Foyle) (SDLP)]

Like other hon. Members, I congratulate the hon. Member for South Antrim (Dr McCrea) and his colleagues on giving the House the opportunity to discuss this very important issue, which, as we have heard, touches many people in many ways, and in ways that they find hard to express or represent. For all the reasons that we understand, it is important that we in the House—again, in our own inadequate and inarticulate way—not only try to express our feelings and represent the feelings of those who have lost people through suicide, but try to feel our way towards some sort of policy answer and structural response to a very serious problem that is growing in many ways.

It is not just because the statistics are better collated that we can say that the problem is growing. There are issues, and people can analyse and compare the different statistical bases over the years. It is a problem that has gradually been able to express itself a bit more. Reference has been made to the fact that it has been a taboo subject. The first time that I heard of suicide was when I was in primary school in the late 1960s, and a family friend committed suicide. She was a great friend of my mother—she was great to all my brothers and sisters whenever we were in her fruit and vegetable shop—and I remember that my mother’s distress as a friend was based not only on all the usual questions that arise from suicide and the loss of a lovely friend. It was also based on the fact that her friend was denied a Christian burial and denied the rites of her own Church. That is what taboo meant then. Luckily, Churches have become more enlightened and many people have helped them to become more enlightened. So we can celebrate the fact that spiritual enlightenment can inform Churches in different ways, and their response to something that they class as a sin can change and develop. That has been very positive and has helped all of us as a community in many ways.

I have found the debate hard. I agreed with many of the points, and I also felt many of the points. I have experienced suicide in my family more than once. I also have experience of suicide by people whom I regard as close—good friends, family friends and so on. All the things that all the right hon. and hon. Members have said are so, so true. We are stuck with that—the questions that will never leave, and the answers that will never come. There are people finding and developing answers, however. Maybe they are not answers to the particular suicide that has grieved me or grieves other members of my family and extended family, but answers as to how we may be able to get on top of the problem and as to how we can avert such tragedy and prevent it from afflicting other people as well.

In many cases some of those answers are being driven by the families and the very people who have experienced suicide, and by the professionals who have witnessed that, provided support and said, “There has to be a better way. There has to be more that we can do. There has to be more that we can do together.” The hon. Member for Bridgend (Mrs Moon) referred to the work of the all-party group and the report. I do not speak often at the all-party group, for reasons that people will understand; I find it hard to contain my emotions on these things. One thing struck me as I was listening to people give evidence to the group—people who did not know which area I represented. A few times when people from parts of England were giving evidence about their experience and the things that they were trying to do in their area with their trusts and well-being boards, they referred to what they called the Derry model, which they wanted to see in their area.

That is because in my constituency, in my city of Derry, as other hon. Members have said, we have grave levels of suicide, but there has been a strong community response and the local Western Health and Social Care Trust has tried to engage strongly on it. The trust has a suicide liaison officer, Barry McGail, who does not just work well locally, but is globally active and is part of progressive policy-pushing networks on the subject. When people spoke about the Derry model, part of what they meant was that suicide liaison service.

The service is notified of a suicide by the police within 24 hours and its staff make family contact. They are there at the wakes, able to talk to the family and friends. They are able to bring leaflets and draw attention to other services in a sensitive way, so the issues are immediately picked up and the people who might be most emotionally affected or vulnerable after the suicide—other family members, friends, classmates and so on—can be identified and supported. That has worked well and has helped families through and has helped them feel that they are helping others, which is so important.

More widely in Northern Ireland, we have a self-harm register, another positive development. It is run now by the Public Health Agency and is co-ordinated on a north-south basis. The register provides up-to-date information on people who may have attempted suicide or have self-harmed, so that the right services can be in touch with them or they can at least know that services such as counselling and other opportunities are available for them. Again, that is important in prevention. It is also important to learn the lessons of experiences and making sure that things that are known to one service are not lost to the knowledge and intelligence of another service that may be the right one to provide help.

Some hon. Members have referred to the media in this regard. Of course, the media have particular responsibilities. They need to be very careful and sensitive in how they present any film or TV storylines depicting suicide. If they make suicide simply the natural conclusion to a narrative, that is completely wrong. Unfortunately, too often in the media it seems as though the suicide itself makes the statement, and that is very dangerous. Equally, the media, whether the print media or any other kind, need to be very sensitive in how they cover deaths by suicide. If they treat speculation about clusters—the hon. Member for Bridgend, who is unfortunately no longer here, has experienced this directly in her constituency—in an insensitive, invasive, exploitative and sensational way, that can add to the problems. It can not only add to the suffering and stress of families, but put more families at risk of loss and distress.

Over a dozen years ago—this is not a new problem in Northern Ireland—people like Barry McGail worked on developing guidelines for the local media to use. One of the guidelines in circumstances where a suicide took place was for the media not to treat it in a way that linked it to a single dramatic event. I found myself in a situation where there was a suicide in another family that followed a death in my own family. With the support of education professionals, people like Barry McGail, and other people in the Western health board, I tried to prevail on the media not to treat the young man’s suicide as a “Romeo and Juliet”-type story. It was a struggle to get the media to comply with guidelines that had been drawn up sensitively with their own co-operation, and unfortunately we did not succeed in all instances. The media do have responsibilities in this regard.

Then there is the new media, with the digital age and all the opportunities that are there. In relation to the sites that offer methods and techniques of suicide and appear to be encouraging it, Barry McGail says that although most young people will engage in social media, most of them will want to do so positively. As well as trying to police and shut down all the negative, dark sites, we need to think of more ways of making sure that there are far more positive connections and real pathways of assistance and communication. We need to develop new things such as apps that will be suitable for young people, in particular, who could be at risk.

That is not to say that only young people are at risk of suicide. In my constituency and elsewhere, it affects the old and the young—mothers, fathers, and children. However, one of the things that gives me heart is that people who have been through these dark difficulties, and who are still not out of all that darkness, are desperately trying to remedy the situation through different networks, charities and support groups. In my town, they are supported by people such as those at Foyle Search and Rescue, who do such a good job in helping families who suffer following suicide in the river. When we were building the new iconic peace bridge in Derry, they worked with us to prevail on the architects to understand that it needed to be designed in a particular way with rails shaped so as not to lend themselves readily to suicide attempts.

Foyle Search and Rescue houses and accommodates various groups of families who have come together. We also have groups such as Zest for Life, which work so well to counsel people who are suffering from problems, and HURT (Have Your Tomorrows), which particularly helps people who have been suffering from addiction or dependency and have specific vulnerabilities. These groups are succeeding in helping to reduce and to solve the problems, but they constantly come up against funding difficulties. There is also the issue of making sure that all the policies and services can mesh together.

Finally, another positive feature in Northern Ireland is the ASIST—applied suicide intervention skills training— model, which has been borrowed from Canada and is working well where people engage with it. The big problem, however, is getting GPs to engage with it—they are not—because they are the vital cog and the key people. The issue has come up in the work of the all-party group on suicide and self-harm prevention. As the hon. Member for Bridgend will know, one of the questions that constantly comes up is: how do we get GPs involved in and engaged with this? Their input is vital and they are vital channels, but in their absence, people’s sense of purpose starts to wane and get weaker.

I am not blaming GPs. Obviously, there are a lot of pressures and demands on them, so they need time out of their practice to do this. We need to see what locum support and other things are available to allow them to play their part in the very good efforts that are being made and to make good the investment being provided by the Department of Health, Social Services and Public Safety. Other Members have been right to acknowledge the work of that Department, including that of the current Minister, Edwin Poots, and his permanent secretary, Andrew McCormick. We should also acknowledge the work of the previous devolved Ministers. It is a pity that the ministerial group did not meet for about 18 months, but that does not mean that other good work was not going on. For that work to be done, it needs to be supported, and I hope that today’s debate will help to support and encourage those people who deserve it in their important work on such a huge issue.

[Mr Deputy Speaker (Mr Nigel Evans)]

To resume his seat no later than 5.35 pm, I call Kevan Jones.