NHS Dentistry: Lincolnshire

Martin Vickers Excerpts

Wednesday 20th October 2021 Commons Chamber

[Maria Caulfield]

My right hon. Friend makes an excellent point, which I was going to address. Officials tell me that the areas where we are seeing significant gaps are referred to as “sheep” and “seagulls,” with the sheep being rural areas and the seagulls being coastal stretches. They are the two areas of the country with a significant shortfall in NHS dentistry provision, and they are the two areas on which we will particularly focus.

[Martin Vickers (Cleethorpes) (Con)]

My constituency contains both sheep and seagulls. One of the problems, of course, is that rural villages and market towns are attracting increasing populations and we are seeing massive planning applications. I cite Barton-upon-Humber in my constituency as one example. What work is the Department doing with local authorities to make sure that, where there are major planning applications, public services and particularly dentistry are sufficient to meet the need?

[Maria Caulfield]

My hon. Friend makes a good point, and across Government Departments we are discussing the provision of both general practitioners and dentists for new developments. I am keen that dentistry is on a par with GP provision, because it is often an afterthought. I am keen that we push it up the agenda, and this debate helps.

Covid-19 Update

Martin Vickers Excerpts

Thursday 22nd July 2021 Commons Chamber

[Nadhim Zahawi]

That is a very important question. The JCVI is constantly reviewing the data from other countries that are vaccinating all children of 12 to 15 years old. Its concern has been centred around vaccinating healthy children. There is a very rare signal of myocarditis on first dose. The JCVI is awaiting more data on second dose. It will continue to review that and will come back to us, and, of course, we will come back to the House.

[Martin Vickers (Cleethorpes) (Con)]

In north-east Lincolnshire, the infection rates has been hovering at around 1,000 per 100,000 for the last couple of weeks, which is of obvious concern to my constituents. I am in regular touch with the Northern Lincolnshire and Goole NHS Foundation Trust, which is doing an excellent job, but could the Minister reassure my constituents that if additional resources are required by the trust, the Department will provide them? The trust has had a big expansion in demand for A&E over the last few days and the trust management asks whether the Department could step up the campaign to encourage people to use the 111 service.

[Nadhim Zahawi]

My hon. Friend’s constituency of Cleethorpes has now done 122,397 cumulative total of doses, which is a tremendous achievement. I will take away his request and come back to him once I have had the chance to discuss it with NHS England.

Do Not Attempt Resuscitation Orders: Guidelines

Martin Vickers Excerpts

Wednesday 21st July 2021 Westminster Hall

[Hannah Bardell (in the Chair)]

Given the extreme heat, both in London and here in the Boothroyd Room, if Members want to speak or intervene without their jackets, that is permitted. I am sure the public will have sympathy. I have also advised the Doorkeepers that they may take their jackets off. Members will also be aware that social distancing is no longer in operation, but I remind them that Mr Speaker has encouraged us to wear masks between speeches and interventions.

[Martin Vickers (Cleethorpes) (Con)]

I beg to move,

That this House has considered guidelines for Do Not Attempt Resuscitation orders.

It is a pleasure to take part in this debate under your chairmanship, Ms Bardell. I will be fairly brief. I welcome the fact that hon. Friends have come along, and I am very happy to take interventions from them.

I requested this debate to raise the important matter of the use of do not attempt cardiopulmonary resuscitation and do not attempt resuscitation orders, which have been widely reported as being overused in recent years, particularly over the course of the covid-19 pandemic. I do not have a science or medical background. I am generally happy to defer to the opinions of the experts, who are far more qualified than me to speak about a patient’s condition. However, we have had a year of frequent and extremely worrying cases, some of which were highlighted by an article by Camilla Tominey in The Daily Telegraph on 12 June. I thank Ms Tominey for providing me with other articles. As a result of reading them, I felt compelled to raise this matter in the House today.

As a result of those reports, there are many people who have real concerns about this issue. Will they be consulted? I do not doubt that the medical professionals involved feel that they are doing their best and that they are acting in the best interests of their patients, but decisions of this kind must be made only after discussions with the patient or, if the circumstances demand it, their next of kin.

The Care Quality Commission published a report on 18 March following concerns raised at the beginning of the pandemic about the use of blanket DNACPR decisions across groups of potentially vulnerable people. It found that almost 10% of DNACPR decisions had been made and communicated inappropriately, involving potential breaches of the individual’s human rights.

Concerns have been raised by other Members during questions to the Prime Minister, the Leader of the House and the Health Secretary. Indeed, last week, when I questioned my right hon. Friend the Health Secretary, he said that a ministerial oversight group had been established to follow through on the CQC recommendations. I hope the Minister will be able to give more details about the work of that group. Many colleagues will have heard and read deeply saddening stories from constituents and citizens across the UK who have been impacted by this seemingly widespread approach.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing this issue forward. When I saw it on the agenda for Westminster Hall, I just knew that I had to be here. As light is spread, Members like me had the same idea. That is why I wanted to be here. During the first wave of the pandemic, there were ongoing issues with DNAR orders. It has been stated that human rights may have been violated in over 500 cases. That is an enormous amount. Every one of us knows people who have found themselves in those difficult positions. The hon. Gentleman made a critical point: when decisions are made for DNAR orders, full protocol must be followed. Most importantly, the next of kin, who really need to know what is going on, have been ignored. That cannot happen again.

[Martin Vickers]

The hon. Gentleman makes some powerful points, particularly, as I just mentioned, about the involvement if not of the patient themselves, certainly of the next of kin.

There have been examples of elderly people who reported that they felt pressured into signing these orders against their will. On 16 June, the Daily Mail reported that research carried out by the University of Sheffield found that 31% of the patients in its study who were admitted to hospital for covid were issued with do not resuscitate orders. That is unacceptable. Decisions of that nature are for the individual. They have the right to make their decisions without feeling unduly pressurised.

There have also been reports of care home residents having these orders imposed without consent and some reports speak of “blanket use”, which again is completely unacceptable.

Another report was of a 76-year-old man being issued a DNAR order following a heart attack, from which he made a full recovery. The order had not been discussed beforehand, but when his wife protested, she was reportedly told to “let him go with dignity.” The situation was only put right after the intervention of a more understanding member of staff and the order was revoked.

Throughout the pandemic, there have also been distressing reports of disabled people being denied vital medical treatment. According to the charity Mencap, a number of disabled people have died prematurely when intervention could have saved their lives. However, such intervention was denied owing to DNAR orders that should not have been in place.

Suffice it to say that some of the stories I have heard are frankly sickening, especially those involving the disabled or those suffering from mental illness. Having said that, I do not want to identify individuals in specific cases, although one widely reported case referred to a former Member of the European Parliament, which is sort of halfway to identifying the person involved. However, as I say, that case has been public for some time. She was admitted to hospital in Oxford for an operation on a broken pelvis. After being discharged, she was, of course, shocked to discover that a DNAR order had been in place, without her knowledge or consultation. In the event, her heart stopped during the procedure, supposedly owing to the fact that she suffers from Parkinson’s disease.

I am sorry to say that, as a result of reports I have read, I am able to come to no other conclusion than that clinicians are making assumptions regarding their patients’ quality of life and chances of survival that frequently are harsh and unnecessary. It is evident that a robust response is required from the Department of Health and Social Care. Any delay is unacceptable.

Ministers from the Department have rightly offered reassurance. However, it is time we saw action. Best practice guidelines are already in place, having been set by the Resuscitation Council UK. However, the examples I have given clearly show that the guidance does not appear to have been adhered to by some clinicians.

[Sir David Amess (Southend West) (Con)]

I congratulate my hon. Friend on securing this debate. Does he agree that when a loved one is admitted to hospital or a care home, whatever their age, when DNAR is discussed with their friends or relatives it has to be handled very carefully, because it could be a great shock? Also, was he aware that a former colleague of ours has said, following my raising this subject at business questions two weeks ago, that her husband had a DNAR order placed upon him without her express consent?

[Martin Vickers]

My hon. Friend makes some important points. I was unaware of the particular case that he mentions, but it is yet another example of what is happening without the approval of the patient or their family.

As I say, Ministers from the Department of Health and Social Care have quite rightly offered reassurance, but clearly some clinicians appear—I say “appear”—to be treating the guidance merely as a tick-box exercise. However, we are talking about life and death decisions.

Decisions regarding our own mortality can be uncomfortable, obviously for ourselves but also for our loved ones. This issue highlights the need for a cultural shift to ensure that everyone feels supported to hold open and honest conversations about what they would like to happen at the end. These conversations need to take place as early as possible, as we approach old age or learn that we have significant health problems. It is only by doing so that we can be sure that our wishes and those of our loved ones are honoured, as well as reducing the distress of the relatives of patients who have chosen to have DNACPR orders in place.

I would be interested to hear from the Minister what she proposes to do to support health and care clinicians, professionals and workers in holding conversations about these orders, and the importance of their involving patients and their families.



Earlier, I referred to the ministerial oversight group. Will the Minister confirm that the Government are thinking about that recommendation? I stress that the group must include health and social care providers, including those in the palliative and end-of-life sector, as well as those involved in local government and voluntary and community organisations. I would be grateful if the Minister confirmed that.

To conclude, the overuse of these orders over the course of the pandemic is a national scandal. Reports suggest that there are people who are not with us today who otherwise would have been. Likewise, some of the lucky ones who have made a full recovery did so despite having one of those orders attached to them. We all recognise that our medical professionals face extremely difficult decisions. This issue deals with profound matters: the relationship between doctor and patient, and for many like me, who regard human like as sacred, the orders go against our deepest religious and spiritual beliefs and cannot be dealt with in a matter-of-fact way. I know that the Minister and her colleagues will take this matter extremely seriously and will want to provide the reassurance and confirmation that it will not be allowed to go on.

Oral Answers to Questions

Martin Vickers Excerpts

Tuesday 13th July 2021 Commons Chamber

[Mr Mark Harper (Forest of Dean) (Con)]

What recent discussions he has had with the Chancellor of the Exchequer on funding for a plan to reform social care for (a) older people and (b) people of working age.

[Martin Vickers (Cleethorpes) (Con)]

What progress he is making on bringing forward plans to reform adult social care.

[The Secretary of State for Health and Social Care (Sajid Javid)]

I want people to be able to get the care they need when they need it and to have the choices they want. I want people to live their life in full and to live independently as part of a community for as long as possible without facing an astronomical care bill. We are committed to social care reform, and we will bring forward proposals this year.

--- Later in debate ---

[Sajid Javid]

First, my right hon. Friend is right to bring to the House’s attention the way that the Government are also working on social care for working-age people. He is also right to point out—I was thinking about this the other day—that around 55% of total adult social care spending is for working-age adults, and it is important that we continue to provide that support. He will be pleased to know that I am working with the current Chancellor and other Cabinet colleagues on bringing forward a more sustainable long-term plan, and I hope he will support it when it comes forward.

[Martin Vickers [V]]

I welcome what my right hon. Friend has said so far and the moves he is making to deal with the social care issue. One thing that elderly people particularly are worried about when they are in care or in hospital are the recent reports of “Do not attempt cardiopulmonary resuscitation” orders. Will my right hon. Friend give an assurance that they will only be put in place with the authority of the patient or their next of kin? Is he making inquiries into recent reports of their widespread use?

[Sajid Javid]

My hon. Friend will be interested to know that the Department commissioned the Care Quality Commission to review the DNACPR decisions that were being made during the first wave of the pandemic. That review was published in March, and the Department then established a new ministerial oversight group that will be responsible for delivery and the required changes that were recommended in the review. We want to ensure adherence to the guidance throughout the system whenever DNACPR orders are used. The first meeting of this new group will take place on 8 June.

Covid-19 Update

Martin Vickers Excerpts

Monday 5th July 2021 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I warn colleagues that this statement will finish at 6 o’clock due to the need to get back to the debate on the Bill, so I urge colleagues to be brief.

[Martin Vickers (Cleethorpes) (Con)]

The majority of my constituents will welcome the Secretary of State’s statement, but NHS Digital data shows that the case rate in the council area is 591 per 100,000. That is considerably ahead of the national average and is causing inevitable concern, particularly among elderly and vulnerable groups. I have full confidence in the local NHS, the council and other officials dealing with the situation, but if it continues to worsen, will my right hon. Friend meet me and my hon. Friend the Member for Great Grimsby (Lia Nici) to discuss whether additional support and resources are required?

[Sajid Javid]

I of course understand the importance of my hon. Friend’s question. As I said in my statement, I believe that the case rate nationally, including in his constituency, will worsen, but the hospitalisation and death rates are far more important. He will have heard what I said earlier, but I am more than happy to meet him on any occasion to discuss such issues further.

Social Care Reform

Martin Vickers Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

The hon. Gentleman makes a really important point about respite for carers. Being a carer is hard and back-up support and respite services help make it more possible, but frustratingly, during the pandemic many of those services have not been able to function as normal. I am currently working with Ministry of Housing, Communities and Local Government Ministers to help local authorities across England ensure that day services and respite care are fully restarted as that is very important, and I would like to see that across the whole of the UK.

[Martin Vickers (Cleethorpes) (Con)]

I appreciate this is very difficult for the Minister, because until we actually know what the Government’s proposals are, she is answering questions based on assumptions and guesswork, but she will know that the main concerns of families are twofold: that they get adequate care; and that they will not have to sell their family home to provide that care. What assurance can she give that the Government will take into account the fact that people want to hold on to their family home? On the assumption that the value of assets will play some part in whatever formula we come up with, what account will be taken of the vast difference in prices of property in London compared with, for example, Cleethorpes?

[Helen Whately]

I hope my hon. Friend will forgive me if I am not drawn on the assumption point that he made in the second part of his question, but what I can say to him is that the Prime Minister has been clear that he wants a social care system where no one needing care should be forced to sell their home to pay for it.

Covid-19 Update

Martin Vickers Excerpts

Tuesday 2nd February 2021 Commons Chamber

[Matt Hancock]

As the right hon. Lady knows, we have brought in very significant measures at the border to control the arrival of those from countries at risk, for instance, South Africa and other southern African nations, Brazil and nations around Brazil, and Portugal. The self-isolation requirements that she mentions are absolutely critical, but we are also of course looking at what further measures are necessary.

[Martin Vickers (Cleethorpes) (Con) [V]]

The roll-out of vaccines in north and north-east Lincolnshire is going extremely well and I am sure that my right hon. Friend will want to join me in congratulating all those involved on their magnificent efforts. To follow on from questions about the housebound, yesterday I was contacted by the family of an elderly gentleman who lives alone in a rural part of my constituency, who received an invitation for a vaccination at a centre considerably far from his home, and he wanted it locally. I appreciate that there is a follow-up, but the initial letter can cause confusion for people. Will my right hon. Friend do all he can to assure me that the follow-up letter inviting people for a local vaccination comes swiftly after that first letter?

[Matt Hancock]

Yes, I am happy to work with my hon. Friend. The best thing might be if I ask the Minister for Vaccine Deployment to call him straightaway to ensure that his constituent gets the vaccination as locally as possible.

I also take on board the broader point, because it is not just about that constituent, important though that is; it is also about making sure that everybody can have the vaccine as locally as reasonably possible. We also need a local voluntary effort, which is happening in so many parts of the country, to help elderly people to be able to get to a vaccination centre. If a constituent is housebound, the roving vaccinations teams need to be able to reach them. That takes longer than vaccinating through any other route, for obvious reasons, but it is a very important part of the scheme.

Covid-19 Update

Martin Vickers Excerpts

Monday 14th December 2020 Commons Chamber

[Matt Hancock]

There has to be a 21-day window from the first vaccine dose to the second. We are aiming to send out invitations so that people can come as close to that 21-day marker as possible. Clinically, the 21 days is a minimum not a maximum, but the goal is clearly on or as close to the 21st day as possible.

[Martin Vickers (Cleethorpes) (Con)]

As my right hon. Friend is aware, my constituency is in tier 3, and although there has been a considerable drop in the infection rate, people are still concerned about the roll-out of the vaccine. Can he give an update and an assurance that my constituency will feature in the roll-out in coming weeks?

[Matt Hancock]

Yes, we are working very hard to get the vaccine to every part of the country, including Cleethorpes. I will look into exactly when the vaccine is arriving in Cleethorpes and get back to my hon. Friend as soon as possible.

Covid-19 Restrictions: South Yorkshire

Martin Vickers Excerpts

Wednesday 21st October 2020 Commons Chamber

[Edward Argar]

As the hon. Lady will have heard me say, the combined support schemes, particularly where there is the UC top-up, will mean that people get at least 80% of their wages. I am afraid that I refute her point about the living wage in this country, as I believe it is a significant achievement by this Government and the previous Chancellor, George Osborne. It is a huge step forward, and rather than belittling it, we should recognise the impact it has had.

[Martin Vickers (Cleethorpes) (Con)]

South Yorkshire is where many, perhaps most, visitors to Cleethorpes come from. They are very welcome and vital to the local hospitality sector, but many of them occupy caravans and chalets for weeks and months at a time. Again, that is welcome, but there are concerns among local people that people perhaps come and go during this period to and from an area in tier 3. What support can the Government offer to the local authority to monitor that?

[Edward Argar]

My hon. Friend highlights an important point, and we have been clear that people in tier 3 areas should not undertake travel in and out of that area. They should abide by the rules of the area in which they live, rather than travelling to another area and applying the rules in that area. The rules apply on the basis of the area in which someone lives.

Covid-19

Martin Vickers Excerpts

Monday 28th September 2020 Commons Chamber

[Martin Vickers (Cleethorpes) (Con)]

Like some of my hon. Friends, I rise to give qualified support to the Government. It is qualified inasmuch as we all have reservations about one or two of the decisions that have been taken but, overall, we recognise the enormous challenge presented over the past six months. For those such as my right hon. Friend the Prime Minister and his colleagues, who are instinctively libertarian and freedom loving, the decisions to restrict the freedoms of the British people have been very difficult. The Government have, on the whole, acted rationally and proportionately in their decision making, and the public have clearly recognised that: only a few days ago, a YouGov poll showed that 78% of the British public supported the most recent restrictions. It is fair to say that in a constituency like mine, which has been fortunate to have a very low infection rate, another 5% could be added to that proportion, without any doubt.

If we are to move forward, we will have to retain the good will of our citizens, and to do that we have to be honest and straightforward with them. To some extent, that may involve admitting the occasional error in the past. We also have to take them forward by bringing them into the debate. We need to explain our policies, and when announcements are made, we need to give reasons. If we do not, we leave an open goal for our critics. Of course, there will always be anomalies in the various guidance that is provided, because guidance cannot cover every individual circumstance, but when we are talking about restricting people’s freedoms, we do need to bring them onside.

The availability of tests has been a great challenge. I urge Ministers to ensure that no one enters a care home unless they have been tested and cleared. The other particularly vulnerable group with which I have had dealings in my constituency are those who live with clinically vulnerable people. They have made additional sacrifices—perhaps they are not going out as much or enjoying even the limited leisure activities that are currently available—and we need to give them additional support.

My Cleethorpes constituency is, partly, a tourist destination. It is particularly important that we recognise that another lockdown would mean some businesses going under. We have to recognise that if, by Government decree, we prevent someone from carrying out their normal business, which is perfectly legal and successful, we need to take action to support them. That applies in particular to the self-employed and freelancers, whom we have heard about during this debate but who have fallen through the net in recent debates.

Let me turn to sporting activities. A couple of weeks ago, I met the chairman of and the majority shareholder in Grimsby Town, which is my local football team. Grimsby Town is a league two team with its home ground in Cleethorpes, and very much part of the local community—for example, it is involved in the delivery of the National Citizen Service. The club needs half a million pounds to survive this season, but it is realistic: although it is a financially sound club, it recognises that it should not be the taxpayer who supports it. We have only to look at the football sector, with the transfers in recent weeks, to realise that adequate resources are available in football to support the lower-league teams. If the Premier League is not prepared to take action—I know that negotiations are taking place—I urge the Government to force it to take action.

With some reservations, I have supported the Government’s approach up to now. I say to my colleagues that although this may be a time to give the Government a nudge in the right direction, it is not the time to defeat them. We need to hear from the Government a strategy for the coming months. We do not need to hear definite dates—we cannot give definite dates; it is no good saying that on 1 January we will do this or on 1 March this will happen—but we can lay the foundations and put in place markers so that we know that when we get to certain points, we can release of some of the restrictions we are placing on our citizens.