The National Health Service

Debate between Mike Gapes and Luciana Berger

Wednesday 23rd October 2019 Commons Chamber

[Luciana Berger]

I thank my right hon. Friend for making that really important contribution, and waiting times are a particular issue in our NHS, especially in the Cinderella of all Cinderella services, our CAMHS. Too many young people right across our country are struggling to get a referral and then, if they do get that referral, having to wait months on end. Frankly, it is unacceptable.

[Mike Gapes]

There is a further problem with teenagers when they reach the age of 18, because there is a gap between the CAMHS and adult services. Far too often, young people who have been given help when they are 16, 17 and 18 suddenly fall off the cliff and there is no support for them.

[Luciana Berger]

I thank my hon. Friend for making that important contribution. There is a cliff edge in our young people’s mental health services when they transition into adult mental health services. They have to start all over again and repeat themselves. There are a few places across the country that are creating mental health services for young people up to the age of 25, and that is welcome, but it is the exception rather than the rule. We need to do everything possible to ensure that young people have continuity of support in their mental health services at that fragile moment in their life, because not receiving that critical support can have a detrimental impact on their ability to access education, to maintain relationships with family and friends and to get into employment.

I am particularly concerned that we have seen a serious reduction in the state of our services in the past year. I refer to the Care Quality Commission’s “State of Care” report, which came out this month. It looked at acute wards for adults of working age, psychiatric intensive care units, child and adolescent mental health in-patient services and in-patient services for people with learning disabilities or autism, and it found a significant increase in the number of those services that are now rated inadequate. Those are services for some of the most vulnerable people in our country, and we should be improving them rather than seeing an increase in inadequate ratings from 2% to 8%, 9% or 10%. That is unacceptable, and I hope the Minister will address that serious point in his response. In particular, we know that this is as a result of too many of the people using mental health and learning disability services being looked after by staff who, according to the CQC,

“lack the skills, training, experience or support from clinical staff to care for people with complex needs.”

Again, I hope the Minister will respond to this important point.

This is not just about care for people with mental illness or disability. We are seeing that same story right across our NHS, with patients waiting far too long. We have heard significant figures, with millions of people across the country struggling to access services. They are also having to travel too far for the treatment they need, and too many areas still have too few staff and not enough resources. That is reflected in the 2019 British social attitudes survey, which shows overall satisfaction in our NHS falling by 3% in the last year to 53%. The main reasons given for that include long waiting times, staff shortages and a lack of funding.

Notwithstanding the announcements in the Queen’s Speech on patient safety and changes to mental health legislation, which I welcome, I want to reinforce the point I made to the Secretary of State that this is not just about changing the Mental Health Act and that we need to have the resources for the capital infrastructure to ensure that we raise the standard of mental health in-patient settings to the same standard as physical health in-patient settings, along the lines of the recommendations given by Sir Simon Wessely, who conducted that important review for the Government.

Let us be clear that the pressures on our NHS are urgent and that they demand action, before we even contemplate the existential threat to our NHS because of Brexit. I want to talk about Brexit, because we did not hear about it today from the Front Benches. We had a reference to it from the Secretary of State, but not an actual analysis of how Brexit will impact on the provision of our national health service. We know that the impact on our economy so far from Brexit has been between 1.5% and 2.5% of GDP since 2016, and by the Government’s own assessment, Brexit will impact on our GDP by up to 9.3% over the next 15 years. We are still waiting for those further economic impact assessments on the withdrawal Bill that we have seen in the past week.

We have already discussed the impact of Brexit on our NHS workforce. We know that 63,000 EU nationals work in our NHS and that 104,000 work in adult social care. We should be lining up to thank each and every one of them for the role they play and the contribution they make to our national health service, instead of making them feel like unwanted strangers. I am surely not the only MP who has received representations from people who are serving our NHS and social care service, who go above and beyond under incredible pressure to provide the best possible levels of care and who are feeling worried about what the future holds. They are particularly concerned about the Home Secretary’s proposed immigration rules and the damage that they will inflict on our ability to recruit doctors, nurses and social care workers from the EU and the rest of the world.

I could talk about the threat of access to medicines, the creation of a new medicines approval regime, which will lead to further delays, and the impact on medical research.

European Union (Withdrawal) Act

Debate between Mike Gapes and Luciana Berger

Friday 11th January 2019 Commons Chamber

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

Few debates in this House have ever had such an impact on the people of Liverpool Wavertree and on the country as the one we are conducting this week. Every home, every business and every citizen in Liverpool will feel the impact of Brexit. The stakes could not be higher for jobs, the price of our goods, wages, the cost of mortgages, businesses large and small, our economy and our standing in the world. It is hard to see what has changed since the Prime Minister delayed the meaningful vote in such a discourteous fashion before the Christmas recess. The only tangible change is that the hands of the clock have moved ever closer to the Brexit deadline, with the Prime Minister presenting her false choice of her deal or no deal. She should tread carefully.

There are those who wish to see Britain crash out of the EU without a deal in place, as the final act in their anti-EU drama. No responsible Government should even entertain the prospect of a no deal Brexit, and it is beyond belief that that option has not been ruled out, given the uncertainty that it is creating across our country and the billions being spent in preparation for that possibility. We should be crystal clear about what a no-deal Brexit would mean for our constituents and the country, including for our food prices given that 30% of our food supplies come from the European Union. Our gas and electricity prices would also increase disproportionately, having an impact on the poorest and most vulnerable, as about 5% of our electricity and as much as 12% of our gas is imported from the EU.

With no alternative currently in place, our constituents will no longer be covered by the European health insurance card, and will need to pay for health insurance when they go abroad. The manufacturing sector that I represent in my constituency will be hard hit, with firms relying on just-in-time production unable to properly guarantee their production. I have heard from many of my constituents, including Rob, the owner of a small chemicals business, who would struggle to source raw materials or maintain the same level of sales. He is an employer, and many of my constituents rely on jobs in his firm.

Worst of all, our public services, including the national health service and social care, would suffer as we would be unable to recruit from countries within the EU. In the Select Committee on Health and Social Care, we heard that there is a real threat to medical supplies. The permanent secretary at the Department for Health and Social Care told us that he was having sleepless nights over the continuation of imports of vital medical supplies, and that the issue was very complex.

In Liverpool, we are proud of our universities, and we have welcomed students and academics from across the EU. Our university leaders tell us that crashing out of the EU is one of the biggest threats to our higher education sector. The Russell Group reported just last week that postgraduate student enrolment from EU countries has already fallen by 9% this academic year, starving our universities of cash. More than 100 universities have warned of an academic, cultural and scientific setback from which it would take decades to recover, because a no-deal Brexit would isolate and hobble Britain’s universities.

Those are the things that we can predict with confidence, but the real threat comes from the unintended consequences—the 1,001 things that we cannot foresee that will have a negative impact on our citizens’ lives. The bottom line is that things will be worse for most of the people we represent. That is the reality that we are contemplating in this debate. Our politics is broken and our system has failed, and neither the Prime Minister’s deal nor the no-deal scenario has the support of a majority in this House. Our Parliament is in a state of gridlock, so how can we break it? The Prime Minister could draw a magical rabbit from the hat—a political masterstroke of some kind—that breaks the logjam and enables Parliament to move ahead beyond the current paralysis. While we live in hope, the chances of that happening appear incredibly slim.

The opposition to the Prime Minister’s deal is about more than the backstop on the Northern Ireland border, critical though that is. I am grateful to my hon. Friend the Member for Hove (Peter Kyle) for analysing the debate that was abruptly brought to a close before Christmas. He found that Members from across the House had many concerns about security, migration, citizens’ rights, and trade and the economy, which was the No. 1 issue. However, the backstop, on which we are told this whole debate rests, came fourth.

[Mike Gapes]

As somebody who was involved in negotiating the Good Friday agreement, I regard the backstop as an essential guarantee of that agreement and of long-term stability in Ireland. Although I disagree with the Government’s position for the reasons that my hon. Friend is setting out, the backstop is not the problem. The problem is with the future framework and other things.

[Luciana Berger]

I thank my hon. Friend for articulating clearly that, although the nub of the issue has rested on this point, there are actually many other issues. For many colleagues on both sides of the House, the backstop is not the issue that is consuming them. In The Daily Telegraph this morning, an unnamed Minister said that the Prime Minister is likely to lose by 200 votes next week because the situation will not be resolved by addressing the backstop alone. If the vote is lost next Tuesday, a motion of no confidence in this Government should be brought immediately, and we should see whether there is a majority in Parliament for a general election. With fewer than 80 days to go until we are due to leave the EU—around 40 sitting days—time is pressing.

If the vote falls next week, we will break the gridlock only by giving the country a final say with a people’s vote, but that does not mean a rerun of the 2016 referendum. The world is a different place nearly three years on. Some 1.4 million young people who are eligible to vote today were too young to have their say in 2016, and the most recent analysis shows that 72.5% of my constituents now support remaining in the European Union, with 74% of people wanting a people’s vote. Those percentages are hardly surprising, because Liverpool is proudly a European city. We were the European city of culture in 2008—a year that generated an economic impact of £753 million. In just the past five years, European structural and investment funds have provided Liverpool with nearly £200 million, which has allowed us to invest in hundreds of local enterprises and jobs. People understand the enormous benefits that EU membership has afforded us for decades, and it is regrettable that the Government will not even confirm that funds that the European Union has already committed to Liverpool to the tune of millions of pounds will be guaranteed post Brexit.

Young people, whose lives will be most affected by the decisions taken in this place, should be allowed a say on their future. New facts have come to light. The lies of the leave campaign have been exposed, including, as the House heard earlier from the Home Secretary, the leaflets and Facebook advertising that people were bombarded with telling them that millions of people would come here from Turkey. That was just not true. We have heard strong suggestions of Russian influence in our referendum in line with Russia’s desire to disrupt and weaken the western allies, and it is deplorable that we have not yet seen a full and proper criminal investigation. Rather than the unicorns and rainbows that too many of the public were sold, we now have a much clearer sense of what Brexit actually means for our economy, for jobs, for our public services and for businesses, and public opinion has shifted based on the harsh realities rather than the false, shiny promises on the side of a bus or threats of a Turkish invasion.

Let the people have a say with a people’s vote. Let us be open and honest with the country: there is no better Brexit. There will be no Brexit dividend, just Brexit chaos and misery. There is no better deal than the one we have already. On every analysis, Government receipts will be lower than if we had remained in the European Union. Of course, we could choose to spend money differently, but that is not a dividend. The decision will affect us for decades to come, and it is in the national interest and for the sake of the people of Liverpool, Wavertree, who sent me to this Parliament, that I will vote against the Government’s motion next week.