(2 years, 6 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Mr Efford.
I, too, congratulate the hon. Members for Waveney (Peter Aldous) and for Bradford South (Judith Cummins) on securing this important debate. Lots of important points have been made about the situation nationally and about the contract, and some solutions have been offered.
I will use the short time available to pay tribute to Healthwatch Richmond, which back in the 2020 was the very first Healthwatch in the whole network to express concerns about dentistry. It was the first to produce a report on it, which prompted Healthwatch England and various local Healthwatches to do so. I pay tribute to Healthwatch Richmond’s lobbying of Healthwatch England and NHS England for bringing us to the point where we have the information to hand and can put pressure on NHS England and on Ministers. I thank Mike Derry for his work.
I also want to give a voice to my constituents. Yes, the London Borough of Richmond is a relatively affluent borough. That does not mean that there is not need and that everyone can afford to go to a private dentist. Our borough has the lowest funding for NHS dentistry in London, apart from the City of London, and the Healthwatch Richmond survey found that less than half of those seeking NHS care could get a routine appointment. One in three could not even access urgent or emergency care; private patients were 16 times more likely to be able to access treatment. Clearly, the problem is not with the supply of dentists, because those who needed to get treatment, if they are able and willing to pay, could access care in the space of a week. Hundreds of others, however, could not access such care.
I want to bring two or three examples to light. Only last month, a resident of Hampton wrote to me. She is a full-time carer for her daughter and they both have special needs. She was tearing her hair out, because she had phoned scores of NHS dental practices but no one would take her daughter. She said:
“I have to use my disability money and my heating money and food money to pay £700.00 to help my daughter. I even wanted my dental practice to give my daughter my place at the practice as she is in so much pain.”
They have various special needs and are concerned, as so many are, about the cost of living crisis—she has heating bills and food bills, but here she is having to pay for care.
Another recently retired individual, whose income dropped significantly in retirement, said that they ended up paying
“£1000 for x-rays and the 30 second removal of the implant! The second dentist I went to in Twickenham quoted me £6k for removal of a wobbly tooth and replacement”.
That is simply not affordable, and it is unfair to say that affluent boroughs such as Richmond do not need additional NHS provision. There are countless more stories. As we have heard, prevention is important. Another resident who wrote to me eventually ended up getting referred to hospital for emergency treatment months after they should have been treated.
I have sympathy for the argument made by the hon. Member for North East Bedfordshire (Richard Fuller) that, clearly, there is not a bottomless pit of taxpayer cash allowing everybody as much NHS treatment as they need all the time. We know it is a false economy to restrict NHS access because people are, as he pointed out, ending up in A&E and with far worse problems down the line, which costs the NHS a lot of money.
I agree with what the Father of the House, the hon. Member for Worthing West (Sir Peter Bottomley), said about everybody being entitled to NHS care. I know the Minister will talk about the recent £50 million injection of cash into NHS dentistry, but that will offer just 350,000 appointments. Nine million children missed dental appointments in the year following the first lockdown. The Liberal Democrats are calling for a minimum standard of service, with a personal dental plan that helps people to understand how frequently they need a check-up, gives them good advice on looking after their teeth and, critically, includes access to an NHS dentist. I look forward to hearing what the Minister has to say to my constituents and millions of others around the country who cannot access the care that they need.
(2 years, 6 months ago)
Commons ChamberThere is a reason why on average every month since I became an MP just over two years ago, I have raised the issue of children’s mental health, including in my maiden speech: from the moment I got elected, a relentless stream of parents, carers and young people have come to me who have often waited a year or more—six months if they are very lucky, but more likely a year or more—to access desperately needed support.
I get warm words from well-meaning Ministers and promises about all the things they are doing, but the reality is that we are not seeing that on the ground. That is why accountability is key. I have been discussing with Ministers behind the scenes for two years the need for much more detailed operational spending at a local level on children’s mental health—and for reporting on waiting times, because we do not have the data to track progress. On that very issue, I hope that, next month, Ministers will back my private Member’s Bill for an annual report to Parliament on children’s mental health.
Behind every number we have heard today, there is a child who is struggling to do everyday, normal activities that every young person should be able to do—tragically, some take their own life, as happened with a year 11 pupil in my constituency last year—and parents who are tearing their hair out. The tragedy is that, if we intervened earlier, we would not end up with so many children in crisis. One mother came to see me a couple of weeks ago. Her 15-year-old was referred for anxiety in 2019; she is still waiting for treatment and now her needs are much worse, so she has to go to the back of the queue of another waiting list for a tier 3, instead of a tier 2, intervention. My local headteachers say that they are overwhelmed. They have seen a 50% to 100% increase in need since the start of the pandemic. They are buying in additional support, but their staff cannot cope with the volume and the complexity of need.
I witnessed, in a primary school, a seven-year-old having to be locked in a classroom because he was rampaging around with various items, attacking pupils and staff. That child is now on a CAMHS waiting list; in the meantime, he faces potentially permanent exclusion, and a mother living in fear at home. Is this acceptable for these children today? So many primary schools I speak to are relying on parental fundraising and donations to pay for mental health support.
It is no exaggeration to say that we need a wartime effort to tackle this crisis. We need a trained counsellor in every school—surveys have shown that they want to do more work, so there is workforce capacity—as well as community mental health hubs and more specialist provision. We owe it to those children.
(2 years, 6 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
My right hon. Friend makes an important point, which was made by my hon. Friend the Member for Bridgend (Dr Wallis) earlier. I am sure that the shadow Secretary of State will be asking his colleague in the Welsh Government where their plan is.
The Minister will be aware of the shocking 77% rise in the number of children needing specialist mental health care for suicidal thoughts and self-harm between 2019 and 2021. Headteachers in my constituency cite that as a No. 1 issue, but their staff simply cannot cope with the numbers and severity of need. Parents are beside themselves as their children in crisis are sometimes waiting a year to access treatment. As it is Children’s Mental Health Week, will the Minister make a commitment to children, young people and their parents up and down the country that children’s mental health will be an urgent priority alongside all the urgent operations that need to be done?
(2 years, 7 months ago)
Commons ChamberWhen we protect ourselves by having a vaccination, we protect others. My hon. Friend mentioned omicron, but we have seen other variants before, and we will no doubt see more in the future.
Before Christmas, the JCVI issued the welcome guidance that five to 11-year-olds who are either clinically vulnerable or living with someone who is immunosuppressed should be vaccinated against coronavirus, but since then we have heard very little. Can the Minister tell me when the roll-out to five to 11-year-olds will start, whether it will take place in schools or in vaccination centres, and how those who are immunocompromised will be identified—this is very important to those who are living with someone in that position—given that their GP records will not show their condition? I declare a personal interest.
(2 years, 8 months ago)
Commons ChamberFor now, we think the Government have struck the right balance. The measure is limited to nightclubs and larger venues. However, as the Secretary of State knows, we listen to the chief medical officer, we listen to the chief scientific adviser, we listen to the scientific advisory group for emergencies, we listen to the NHS and we make decisions based on evidence. If ever the Government want to come forward with further proposals, we will consider them in a genuinely bipartisan way and we will act in what we believe to be the national interest. I do not think anyone would expect less of us.
With the covid passes, there is the option of using a lateral flow test or double vaccination. Does the hon. Member recognise that double vaccination, which many people will use, gives a very false sense of security? We know that someone can be vaccinated and still transmit. Most of the people we know getting covid at the moment have already been vaccinated. Double vaccination is not very effective, and it will give a real false sense of security.
I think the hon. Member should look at the evidence from our friends on the continent, which is that this approach not only works in giving people confidence to go out and enjoy themselves, but encourages people to take up vaccination. On that basis, I think the Liberal Democrats ought to reconsider their position.
(2 years, 9 months ago)
Commons ChamberWe are always looking at ways to improve productivity, but we know that on the current figures there are 100,000 staff vacancies in the NHS. No amount of productivity gains will cover for that.
The hon. Member for North East Bedfordshire (Richard Fuller) talks about efficiency, but the figures show that in 2019-20, some £6.2 billion was spent on bank and agency staff. If we are talking about efficiency and using all the extra money the Government are saying they will put in to catch-up, we need to provide value for money for the taxpayer. Therefore, long-term planning to recruit the right skills is critical.
I thank the hon. Member for her intervention. The point about agencies and locum spend is not a new one. It will be interesting to see the figures for the last 12 to 18 months when the Minister has finally ratified them, because I suspect they will be even higher than those we have heard recently.
I believe it will. I am grateful to the hon. Gentleman for raising that issue, because medical training is relevant to the whole United Kingdom, not just one part of it. I hope the amendment will be beneficial to Northern Ireland as well.
If we put ourselves in the shoes of any frontline doctor, nurse or care worker, we would see that they are all completely realistic that this is not a problem that can be solved by next Monday. It takes a long time to train a doctor or nurse. All they have is one simple request: that they can be confident that we are training enough of them for the future, so that even if no immediate solution is in place, there is a long-term solution. That is the purpose of amendment 10. It simply requires the Government to publish every two years independently verified estimates of the number of people we should be training across health and care.
The Government have recognised the pressures on the NHS by giving generous amounts of extra funding. I commend the Government for doing that, but extra money without extra workforce will not solve the problems that we want to solve. At the moment, the NHS just cannot find the staff.
I congratulate the right hon. Gentleman on amendment 10 and on how he has built such a coalition of support. Many of the challenges facing those with mental health concerns are because, as he says, there simply is not the workforce—it has hardly grown over the past decade. There are over 16,600 full-time equivalent vacancies and a waiting list of 1.5 million. His amendment, which would require a report every two years, is so important for ministerial accountability because the targets in the five year forward view have not been met, so we have no chance with the 15-year projection.
The hon. Lady gives a good example, because mental health is an area that we have all recently come to realise can be immensely beneficial to ourselves, our families and our constituents. However, while there has been explosive growth in demand, we have not had growth in the supply of people able to look after those with mental health issues. We can only do that with the kind of long-term planning that amendment 10 will make possible.
The royal colleges say that, as of today, there are shortages of 500 obstetricians, 1,400 anaesthetists, 1,900 radiologists, 2,00 A&E consultants, 2,000 GPs, 39,000 nurses and thousands of other allied health professionals. That is why this problem has become so acute.
The Minister has engaged thoughtfully with me on the issue on a number of occasions. He and I both know that there is some concern in the Government about the cost of training additional doctors and nurses. I want to take that concern head on. Yes, the amendment would lead to more doctors, nurses and professionals being trained. Yes, that would cost extra money. Yes, it would save the NHS even more money, because every additional doctor we train is an additional locum we do not need to employ. Locums are not only more expensive for the NHS, but less good for patients. Patients prefer to see the same doctor on every visit if they possibly can, which is much harder with a high number of temporary workers.
(2 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I thank the hon. Member for raising that important point. I agree that it is simply unacceptable.
Before my constituent left, the GP told her to come back when she wanted to get pregnant, leaving her to figure out how to cope on her own in the meantime. Her story of feeling shamed by her peers and gaslit when trying to get a diagnosis is not unique, as many Members have raised. On average, it takes eight years to diagnose a woman with endometriosis, and years to diagnose PCOS, which brings me to my next point.
The Government need to increase funding to study both conditions. We still do not know what causes endometriosis, effective ways of preventing it from spreading to other organs or effective non-surgical ways of managing symptoms. Some 58% of women with endometriosis had to visit a GP more than 10 times to get a diagnosis, while 21% had 10 or more hospital appointments and 53% went to A&E, with 27% going more than three times, before diagnosis. That is deeply distressing for the patient and a terrible use of NHS resources.
The hon. Lady makes an excellent case and I absolutely support everything she says. I was horrified to hear from a constituent, a qualified nurse, whom it took six years diagnose to diagnose. After two and a half years of daily bleeding and pain, she was finally offered laparoscopic surgery, but was then told by healthcare professionals that the only cure for her was to actually conceive and have a baby, while at the same time being told that she could have fertility problems. Does that not highlight that there needs to be a lot more awareness and education among GPs and healthcare professionals, and adherence to National Institute for Health and Care Excellence guidelines?
I absolutely take the hon. Lady’s point. In the spending review, money for elective procedures was allocated to clear some of that backlog. People are waiting a long time, and every effort will be made to clear the backlog as soon as possible.
I reassure colleagues that we want to ensure not just that there is an evidence-based pathway for both endometriosis and PCOS in the NICE guidelines, but that it is followed in clinical settings, so that women know what to expect; in clinical education, to improve both undergraduate and postgraduate training, so that clinicians have the knowledge that they need on both conditions; and in primary care, to ensure good robust knowledge among GPs about both conditions, which are not just about bad periods or abdominal pain, and about the referral pathways that should be followed. On school education, it is so important that young women know what is and is not acceptable in relation to both conditions, so that they are pushing GPs rather than waiting seven to eight years for diagnosis or 10 to 12 appointments for an answer.
Research can make a real difference in a number of areas. Before I hand back to the hon. Member for Coventry North West, I reassure colleagues that funding is available. I urge all researchers who want to conduct research in this area to submit applications and bids, because there is no way that we will deal with many of the issues that have been raised today without them.
I will not because the hon. Member for Coventry North West needs time to wind up.
I reassure people that funding is available, and that I am committed to working with the APPG to ensure that it reaches the places it needs to reach.
(2 years, 10 months ago)
Commons ChamberMy right hon. Friend is right to draw attention to that point. We need to keep working on it, but it might be helpful to know that under section 2 of the Act, the Nursing and Midwifery Council has been able to register temporarily some 14,000 nurses, midwives and nursing associates in England, and the Health and Care Professions Council has been able to register more than 21,000 temporary paramedics, operating department practitioners, radiographers and other professionals. That has certainly helped the NHS and the care system.
We have already allowed 13 of the 40 temporary non-devolved provisions in the Coronavirus Act to expire, and at the most recent six-month review we deemed a further seven provisions and part of an eighth suitable for expiry. Last month, as we published our autumn and winter plan, I came to the House to set those out.
Some of the provisions that we are recommending for expiry are some of the most stringent aspects of the Coronavirus Act. They include section 51, which relates to potentially infectious persons and which has been used only 10 times and not since October 2020; section 52, which gave powers to issue directions relating to events, gatherings and premises, and which has never been used; section 23, which relates to time limits for urgent warrants under the Investigatory Powers Act 2016 and which is no longer proportionate to this stage of the pandemic; and section 37, which allowed for the disruption of education for children and young people with special educational needs and disabilities, and which continues to be unused.[Official Report, 22 October 2021, Vol. 701, c. 8MC.]
The Secretary of State has been extolling the virtues of parliamentary scrutiny, which, as many right hon. and hon. Members have stated, has been sadly lacking of this Act and in its renewal debates. Will he give us a cast-iron guarantee that should he decide to bring forward vaccine passports, we will get not just a full parliamentary debate, but a vote on any such measures?
I think that the Government have already been clear that should we try to bring forward what the hon. Lady calls vaccine passports, it would be a decision for the House and it would be a vote. If that happened, we would have to justify it to the House.
In addition, we are expiring sections 56, 77 and 78. Taken together with the 13 out of 40 temporary non-devolved provisions in the Act that have already expired, that will mean that half of the original 40 temporary non-devolved powers in the Act will expire early.
I agree with the comments of the right hon. Member for Haltemprice and Howden (Mr Davis) and the hon. Member for Brent Central (Dawn Butler).
Given the sweeping and draconian powers that this Government granted themselves under the cover of an emergency, Liberal Democrats only very reluctantly supported this unprecedented legislation for an unprecedented crisis back in March last year, when we knew very little about the virus. I am proud that my party pushed hard for a three-monthly review of these powers, which then secured us the six-monthly review. But at each renewal, as has been said so eloquently, there has been limited opportunity to scrutinise or to table or debate amendments.
While there were important measures in the Act relating to benefits, furlough and registration of healthcare professionals, the Government have had ample time since to legislate properly, with proper scrutiny, for those important measures, yet they chose not to. Instead, unnecessary, far-reaching powers encroaching on our civil liberties have twice been renewed, with minimal debate—measures such as detention of potentially infectious persons that I believe have actually resulted in 295, not 292, wrongful prosecutions. That is why Liberal Democrats have consistently voted against the renewal of this Act.
Ministers have proved, as has already been said, that they did not need many of the powers they awarded themselves on restricting gatherings or closing down education settings. I hope and pray we never close any schools again, and I hope that the Secretary of State will give us a cast-iron guarantee on that. Throughout the pandemic, the Government have used existing public health legislation or guidance to impose restrictions, so I am glad that they have finally seen the light and are today expiring many of these controversial measures. It is not before time, but once again we have been granted merely 90 minutes to discuss the remaining legislation. I am afraid that we will see this casual approach to our civil liberties once again with vaccine passports, given the number of flip-flops and U-turns we have had on that subject.
I welcome the Secretary of State’s comments to me earlier that there will be a vote of this House. I reiterate the question of the right hon. Member for Forest of Dean (Mr Harper) about whether we will get a vote in advance of any vaccine passports being introduced, because the track record we have seen with the Coronavirus Act 2020 does not fill me with any confidence in this Government. I urge them to stop riding roughshod over this Parliament and to allow us to do our duty as elected representatives and properly scrutinise, amend and vote on measures that fundamentally curtail our liberties.
(2 years, 10 months ago)
Commons ChamberTeenage vaccination rates in this country are lagging behind other countries. The latest data shows that the equivalent of 8,000 classrooms were empty over the past two weeks due to pupil absence, and schools such as Hampton High in my constituency had 11 teachers missing yesterday yet have been advised against reintroducing masks and have been told to teach 700-plus pupils outdoors. Does the Secretary of State think that that is sensible advice and will he ramp up the vaccination of teenagers, particularly over half-term next week?
We are ramping it up. I can tell the hon. Lady that to make the most of half-term next week, we will be opening up the national booking service to all 12 and 15-year-olds to have their covid vaccinations in existing national vaccination centres, which will offer families more flexibility. It is important that anyone who is invited as they are eligible for a vaccination—including young people—comes forward and takes up that offer.
(2 years, 11 months ago)
Commons ChamberMy hon. Friend is right to raise that. It is a very difficult situation, as of course I think everyone in this House understands. It is one of the reasons we are increasing capacity—there is new funding and support—and it remains a priority.
Could I start by extending my condolences and, on behalf of my party, those of my right hon. and hon. Friends to the Prime Minister and his family today?
Children and young people have done everything that has been asked of them through this pandemic, as have their parents, yet children have paid a high price in lost learning and mental health particularly, and they have been an overthought for the Government throughout. It is all very well announcing today that the power to close schools in the Coronavirus Act will be expired—it makes a great headline—but the Health Secretary is well aware that that power was never used previously to close schools; it was just guidance from the Education Secretary. Will the Health Secretary give pupils and parents across the country a cast-iron guarantee today that his Government will not close schools again this winter?
I think the hon. Lady would agree that we are as a country in a much better place today with covid than we were even at the start of this year. That is down to many factors, and I referred to a number of those in my statement, but I believe that with the measures we have set out today, we can be confident that our children will not have to go again through the kind of disruption they have seen in the last couple of years.