(2 years, 7 months ago)
Commons ChamberThe Secretary of State has come to the House today to say that the freeze in the licence fee is to help hard-working, struggling families. May I ask her to answer the question put to her by the Father of the House: when was this decided? Did it go through a Cabinet Sub-Committee? Did Cabinet sign this off, or is it that just over the last weekend the Government thought they would come up with something that would take the attention away from the Prime Minister?
Cabinet has signed it off. These negotiations have been going on; they did with my predecessor as well as with me. Legally, I had to make my statement in as much time as possible before April, which is why I am making it today.
(3 years, 9 months ago)
Public Bill CommitteesI agree. There are adverts on Amazon in this sector, and treatments offered include fillers, although certain other terms are used. People are not allowed to advertise botox, but they get around that by advertising consultations. In response to the question, many practitioners are not qualified at all and hold no medical qualifications, so how do they get access to botox? They do so because people are signing prescriptions. I fear that a situation may arise in which that practice continues, although it needs to stop.
Another issue is that under the definition the botox can be bought because this is basically a free market, as I see it. A practitioner could then administer the botox to a young person with no regard to that individual’s medical history. A medical practitioner, under the definition, could even be defined as a dentist. That needs tightening up. I do not think that would be onerous for doctors, who are quite rightly prescribing botox injections and other things for perfectly legitimate medical use. Doctors and patients are protected when those uses are laid out.
If I had more faith in the GMC to clamp down, I would be content to leave the situation as it is. I am sorry, but having seen the way the GMC operates, I see that the organisation is not friendly to the complainant or to the patient organisation. It protects the doctor. We took self-regulation away from solicitors, and I have concluded that self-regulation should be taken away from doctors. I did not start with that position, but have come to it.
The Minister promised a Bill on GMC reform in the last Parliament, and one is certainly needed, because frankly, the patient is at a disadvantage in a host of areas, not just this one. It cannot be right that it took my constituent’s case five years to reach the GMC, with huge hurdles to overcome to get there. I hear what the hon. Member for Sevenoaks says, but we should try to tighten things up a bit. The Bill will certainly be improved if we can.
Again, I thank my hon. Friend the Member for Sevenoaks. Many points have been made today and throughout the passage of the Bill that will give us plenty to consider and review.
The GMC publishes guidelines on the ethical obligations of doctors undertaking cosmetic procedures, including guidance on responsible advertising. There is no question as to the GMC’s performance and it being fit for purpose as an organisation. The GMC maintained its track record of meeting regulation standards last year, and it met those standards amid a surge in demand for registration.
The performance review of the GMC for 2018-19 by the Professional Standards Authority, the body that oversees the healthcare regulators, found that good practice was upheld in all 24 standards of good regulation across education, registration standards and fitness to practise. The review confirmed an effective approach to managing a rise in registration applications, progress with the credentialing framework and work to promote fairness in fitness to practise processes.
I hear all that, but I think what needs to happen—I offer this to the Minister—is for her to meet my constituent, Dawn Knight, so she can explain to the Minister the agony that she went through to get justice. The GMC is not user-friendly to patients. The fact of the matter is that, in her case, a doctor was allowed to remain on the register for five years, even though there was clear evidence from multiple women that he had undertaken operations that were, in some cases, life-threatening. Frankly, that is appalling.
The right hon. Gentleman does Dawn great credit by raising that case again, and his words have been noted. He is a tireless advocate. The GMC publishes guidance on ethical obligations for doctors undertaking cosmetic procedures, as it does with all procedures that doctors undertake, which includes guidance on responsible advertising, as I have said. There is another opportunity to continue to raise this matter: I will take his comments away and, as I have a patient safety meeting later today, I will raise them in that forum as well, since this is ultimately a patient safety issue.
The most I can say at this point—Dawn is a case in point—is that I will take away the comments made by the right hon. Member for North Durham, and I know my hon. Friend the Member for Sevenoaks has also heard them. We will consider those comments. It might be that this matter cannot continue within the scope of the Bill, but we will look to continue it. This does not stop here: my hon. Friend the Member for Bosworth (Dr Evans) is introducing the Digitally Altered Body Images Bill under the ten-minute rule, so there will be another opportunity to raise these points. Within the confines of patient safety, this is an issue that we need to continue reviewing.
Will the Minister look at prescriptions for botox as well? There is clearly a market out there and there are medical professionals signing prescriptions and then selling them on, fuelling this market and leading to people who are not qualified giving that botox. Could she look at that?
Of course. I heard that comment in the right hon. Gentleman’s initial remarks. This is a difficult market to police—it is regulated, but it is difficult to police and to know who those practitioners are and where they are selling prescriptions on to. If he knows of any practitioners who are doing that, or is aware of any practitioner who is writing out bulk prescriptions for botulinum toxin and selling them on to other, more ruthless practitioners, or to people who are not even registered to practise, I ask him to please let us know, then we can take that forward.
May I suggest another way of doing this? If the Minister speaks to the prescription licensing body, it will know exactly who is signing huge amounts of botox prescriptions, and one possible way to investigate large numbers of botox prescriptions is to ask whether those people can justify what they are doing. If we go online, we see umpteen adverts for botox treatments, and those people who are doing this are not doctors, so where are they getting them from?
Again, the right hon. Gentleman has done his cause justice by raising those concerns and saying what he has in Committee. We will have a look at that.
That is the point. Part of this is about a process of education to teach people what the dangers are. These products are marketed and sold to people—especially young people—as if they are just like make-up.
Well, they are not make-up—this is a medical procedure that can have life-threatening consequences if it goes wrong. It is clear that some of the advertising on Facebook and other sites is directed at under-18s. The Minister mentioned body image, and the Mental Health Foundation’s report from last year on that issue shows that the marketing is for young people.
This is a probing amendment to get this issue on the record. We need to look at ways to ensure that young people are protected from advertising. It is not newspaper advertising; that is for old-fashioned people like me. It is advertising on Facebook, Instagram and elsewhere. I have raised this issue with Facebook. Of course, we get the usual guff from Facebook: “Oh well, we take them down.” I have even written to Sir Nick Clegg asking whether he will do anything about it. Getting an audience with or response from the Pope would be easier than getting a response from him. Those platforms are making money out of this, and they are targeting their adverts at young people, not older people.
Do not get me started on the Advertising Standards Authority, which is a completely toothless, useless tiger, frankly. It takes down some adverts, but they keep proliferating. The social media companies need to do something about it, because young people are being put at risk and because there is a market. Botox is supposed to be a medically controlled substance, but it is not; it is advertised. The way the companies get around that is that, although they cannot advertise botox, they can advertise a consultation, which just happens to be for botox. Facebook, Instagram and others could take down those adverts overnight and just stop them, but they are not doing that because there is clearly money to be made in this sector. Some of those issues will come out in the private Member’s Bill of the hon. Member for Bosworth on body image, but if we do not tackle them, this Bill could be enacted and the Facebooks of this world could still make money on the back of this sector.
The purpose of new clause 1 is to ensure some oversight over the effectiveness of the Bill. It calls for a report when it is under way so that we can assess whether it is effective. It also relates to advertising and promotion. By raising this issue with the Minister, I want to put on the record that there is an issue. I accept that advertising is not directly within her remit as Public Health Minister, but I want to see what more can we do not just on the targeting of under-18s, but on the broader issue of the way in which big business is trying to circumvent the law—advertising botox is supposed to be illegal.
There are two ways of doing that. The first is to stop the supply of botox from prescribers, and the second is to crack down on it very heavily. The Mental Health Foundation’s report on body image shows that, in this age of the internet and the internet of things, young people are in a terrible situation and are suffering due to their body image. That is reinforced by advertising. Botox is seen as a quick fix, but it is potentially dangerous. We need to try to stop this danger to our young people.
The right hon. Gentleman has made wide-ranging and important comments. I am not sure it was any easier to speak to the former right hon. Member for Sheffield, Hallam when he was in this place than it is now—there is not much change there—but I thank the right hon. Member for North Durham on all our behalf for his efforts to do so. Outside of the Committee and official channels, he still keeps batting away and trying to get results. We thank him for that.
I believe everyone has the right to make informed decisions about their bodies and our role in Government is to support young people in making safe, informed choices and, where necessary, to protect them from the potential harm that cosmetic procedures can do to their health. This Bill is a really important step on that path and in that process.
On indemnity, the Government passed legislation in July 2014 requiring all practising regulated healthcare professionals to have appropriate indemnity arrangements in place as a condition of registration with the regulatory body and, therefore, their ability to practise. For doctors, those regulations came into force in August 2015. Failure to comply may mean that they are dealt with under fitness-to-practise procedures. That means that all practising surgeons are affected by the legislation, including overseas surgeons practising in the UK. I hope that information helps.
I am not against the cosmetics industry. I agree with what the Minister just said—it is about informed choice—but it has to be done safely. I welcome her comments on professionals. The big grey area, which this Bill cannot cover but which needs covering, is those who administer botox and fillers. Most of those people are not medical professionals. They have done “a course” in injections, which in some cases I have seen is just a tick-box exercise. That is the area we need to move on to next—not only who can prescribe, but who can inject these fillers and botox.
As the right hon. Gentleman notes, those matters are not within the scope of the Bill and the Bill will not seek to achieve the points he has made. As I have said before, I will take the comments away and will continue to work on them and review them.
I thank the right hon. Member for North Durham for all his work in this area. On amendment 4, the pressure that young people are put under by social media is undoubtedly a motivating factor behind many of them seeking out these cosmetic treatments. That was discussed at length on Second Reading by the hon. Member for Clwyd South, among others. In many case studies that we have heard, discounts were one of the reasons that a young person went to have one of these treatments.
I note that there is a lot more work going on this area, which is welcome. In January, the Committee of Advertising Practice and the Medicines and Healthcare Products Regulatory Authority issued an enforcement notice to the beauty and cosmetics industry and have started to use monitoring tools to take down posts on social media, which is a welcome development, although obviously we need more.
I completely agree that further work is needed in this area. However, as the right hon. Gentleman rightly notes, it is outside the scope of the Bill. I will be making those points in the debates on forthcoming online harms regulations. I imagine he will be doing the same.
These were probing amendments. I took the opportunity to get them on the record, as it is important to ensure that we tackle this area. I welcome the Minister’s comments on this being an area that we need to look at further. I know the Department of Health and Social Care does not like to bring legislation forward because it is still suffering from the Care Act 2014—
Well, I was told that by a Minister in her Department. One simple thing we could do is to regulate those who administer these fillers and botox. That would be a huge step forward. I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Question proposed, That the clause stand part of the Bill.
My hon. Friend the Member for Sevenoaks has said everything that needs to be said about these clauses.
Are we now debating whether the rest of the clauses stand part of the Bill?
(3 years, 11 months ago)
General CommitteesI will not challenge you, Mr Efford, and I welcome you to the Chair today. We had a debate last week about enforcement and who could and could not enforce the regulations. The Minister promised to write to us last week with a long list of individuals, but we have still not got it.
Well, I am sorry but I have not received it, and I do not think my hon. Friend the Member for Ellesmere Port and Neston has, either. The list would include people who could be designated by the Secretary of State. He could designate, for example, marshals, but I shall leave it there.
In terms of these regulations, my hon. Friend points out a growing trend with this Government: they seize emergency powers. We in Opposition support them because we saw back in March that clear action needed to be taken, but there has been no give and take in terms of trying to involve the Opposition or even Parliament in how the regulations are implemented.
My hon. Friend raises a very good point about the way in which the regulations have been introduced, because it raises a broader issue here. For these regulations to be effective, they have to have public buy-in. We are elected to this place to represent our constituents. We have seen over the past few weeks the utter confusion there is now about what people can and cannot do—added to that is the announcement of just half an hour ago. When the Secretary of State introduced the lockdown regulations for the north-east last week, he excluded any reference to childcare, so my inbox and that of everyone else in the north-east was inundated with people questioning whether they could take their grandchildren to school. I am glad to see that sense has been arrived at this afternoon and the clarification has been made, but that is one example, and these regulations will lead to more confusion, as I shall illustrate.
Again, these regulations have not been well thought through. First, we discussed last week how a relevant place is defined. The first regulation extends the number of places where a face mask is needed in what is deemed a relevant place. Before, it was shops, supermarkets, shopping centres, banks and post offices, but not included were restaurants that could provide table service to customers, bars, pubs or areas of a shop or shopping centre that provided for the consumption of food and drink, and seating areas in coffee shops, supermarkets, cafés and food courts. We discussed whether seating areas in transport hubs were covered, and I got clarification on that from the Minister this week.
The relevant places are then extended to include indoor places of worship, crematoria, burial ground chapels, museums, galleries, cinemas, public libraries, public spaces in hotels such as lobby areas of hotels, and community centres. I will come back to the issue of clubs in a minute. To me, this is not very clear. Many hotel lobbies, for example, have seating areas where people perhaps just want to sit and wait to be checked in, but many hotels have seating areas where someone can order a sandwich or a drink or another type of refreshment, so are those areas excluded? Occasionally, for example, I walk into the Radisson Blu hotel or the Royal County hotel in Durham and ask for a sandwich at the reception, and it is delivered to me as I sit in the reception area. Am I then exempt from wearing a face mask or not?
I will come on to community centres, and I am sure hon. Members will know of similar situations to mine. I have a number of very good community centres in my constituency that provide food, but not regularly. They have seating areas for luncheon clubs and various catered events. Under the definition in the regulations, the community centres should be excluded on the basis that they have seating areas and provide food. Do they actually have to provide food at that time? Are we saying that if they are providing food, people there do not have to wear face masks, or that if they are not providing food, people do have to wear face masks? Those are things that will be very confusing to local organisations. It would be interesting to know how that actually works.
Another issue is the definition of a place of worship. That is pretty simple in that a place of worship is a church, a synagogue, a mosque and so on, but increasing numbers of churches do not actually have fixed buildings. They meet in people’s houses as community churches. I have a number in my constituency, and I am sure that there are some in London as well. Are they covered under the rule of six? I imagine that there would be more than six people in those congregations. Are those houses covered as places of worship? For those individuals, that is what they are. We might not recognise them as traditional places of worship, but for their congregations, they are. Will those congregations have to wear face masks in the houses where they hold their services?
I take the point made by my hon. Friend the Member for Ellesmere Port and Neston about social clubs. Many of them were struggling before the pandemic as it was. Their membership tends to be elderly, so a lot of people will not be going to the clubs. They are no different from pubs, in my opinion—except that, importantly, the regulation around them is more strict because they know exactly who goes in, and there are disciplinary proceedings if things happen. Putting them at a disadvantage is wrong.
I now come to the question of wearing face coverings in nail bars, beauty and hair salons, barbers, tattoo and piercing parlours, massage parlours, storage and distribution centres, auction houses, spas, funeral directors, veterinary surgeons and so on. Based on these regulations, if the hon. Member for Aldershot goes into his barber or his hairdresser to have his locks coiffured, he will have to wear a face mask. I am aware that many women, as well as men—the hon. Gentleman included—have their hair washed when they go to their barber or salon. I am sure that the hon. Gentleman goes to a salon rather than a barber. Does the person have to wear the face mask while they are actually having their hair washed? That creates some very difficult problems, does it not?
I went my local barbers a few weeks ago, where I had a disposable gown put on me. To be fair to them, they were good at making sure that people socially distanced, and hygiene was very good. If we are asking people to wear a face mask when they go to a salon, including when they have their hair washed, that will be very difficult.
The Minister says no, and I am sure that the hon. Member for Aldershot has a different view. Asking a person to wear a face mask when they have their hair washed will cause difficulty, because they will then be sitting in a salon with a damp or wet face mask on. What is the science as to how effective a face mask is if it is wet? I am not a scientist, and we do not have here my hon. Friend the Member for Blackley and Broughton (Graham Stringer), who last week actually went into the science of the way in which face masks work. Clearly, some of the more robust ones might stand up to that use. The one that I have with me may well do—I think it was washed yesterday by Mrs J—but I am sure, Mr Efford, that by the end of your salon appointment some of the more disposable ones would be floating around in the handbasin. Again, the issue is just the confusion that the measure causes.
The other issue is about fines. Clearly, No. 10’s strategy over the weekend was to sound tough on fines: “We are going to start fining people. If people don’t follow the rules, they are going to get fined.” [Interruption.] Does the Minister want to intervene?
Was it wind?
The problem is that what No. 10 was saying might sound tough, but, as my hon. Friend the Member for Ellesmere Port and Neston said, how many people have actually been fined? The problem with these types of regulations is that they are confusing to people, so people are not going to be very clear about how they will be enforced. This does come down to enforcement—we had this discussion last week. I have no problem with a police officer or someone else—I think it was a community support officer under the regulations last week—giving out fixed penalty fines if they think that right. We asked for a definition last week of a TfL official, for example; they are not identified. We also asked another question, because in the regulations there is a long list of people and then there is a catch-all provision whereby it could be anyone whom the Secretary of State designates to give those fines. That is why my hon. Friend and I raised the issue about marshals. I do not want to go down that path and upset you in any way, Mr Efford, but if the Secretary of State actually gave local authority marshals the power to issue fines, I would find that very uncomfortable; I am quite happy if people have had training in dealing with these situations. We were offered a list last week, but I am still waiting for it.
This does matter, because we are now extending the regulations to other areas. I come now to my closing remarks, which are about the entire Government approach to this area. We are supposed to be seeing now a super-duper new communications centre at No. 10, but frankly, there is confusion outside the House and these provisions will add to it. The unintended consequences of some of the regulations that have been brought in lead to that confusion, and it is made worse by some Ministers who try to act tough in the way in which they put things over. It is important that we be able to communicate the position, and I do not think we can, with the way these provisions are structured. The Government have been remiss. We should have had more opportunities for debate. I am glad to now hear from Conservative Back Benchers the arguments for why we need more scrutiny of these things in Parliament, which would allow us, as representatives of the people, to have a say before they actually come forward.
There were an extensive number of questions from the hon. Member for Ellesmere Port and Neston, but if he does not mind, I will first answer the questions from the hon. Member for North Durham.
Absolutely. I do apologise: he is right honourable—he will be “Sir” soon.
On face masks for hair washing, salon owners have a responsibility to their staff and themselves and to their customers to keep everyone safe. I hope that my hon. Friend the Member for Aldershot will not mind my saying that I am not quite as follicly challenged, and I had my own hair washed at the hairdressers two weeks ago and I wore my own mask. I will admit that the ties that went behind my ears got slightly damp, but there were no masks floating in sinks or anything like the other extravagant descriptions that the right hon. Member for North Durham provided us with about a day in the hairdressers. There were no problems whatever. I have yet to see anybody not wearing a mask walk into a hairdresser’s salon without their being given a mask by the staff there. It would be extraordinary if somebody had an appointment at a hairdresser’s salon and just walked in without wearing a mask. So, the answer is, “No—that is not a problem at all”.
I accept the point the Minister is making, but until now there was no indication that people actually needed to wear a face mask. She talks about her own experience, but how, for example, would a hairdresser cut the hair of the hon. Member for Aldershot, or shave it round the sides, if he had a face mask on? Does that not make it very difficult?
The tie on a face mask is close to the skin; it is not worn in the hair. It is worn like a hearing aid—around the skin.
I literally cannot go into the ins and outs of a hairdresser’s means and ways of cutting somebody’s hair, Mr Efford; all I will say is that we have had no complaints.
The right hon. Gentleman raised the issue of worship in homes—the answer is a very blunt no. Houses are not covered. He also mentioned hotels and hotel foyers. Again, if there is a bar or a café inside the hotel, or wherever one may be, then one is allowed not to wear a mask.
I will ask for an answer on that one. I would imagine that if it were in an environment where food was normally served in a hotel, it would not have to be open, although I will wait for a definite answer.
However, I would challenge the right hon. Gentleman—and I will answer a question asked by him and the hon. Member for Ellesmere Port and Neston during this debate about the figure of 96% of people wearing masks. That figure came from the Office for National Statistics. It was not a case of what the right hon. Gentleman suggested, but with the ONS—people were actually just answering a survey. All the people here have been going around shops and hairdressers, and it is hard to go anywhere in a public space and find anyone who is not wearing a mask. However, I have asked for an answer about whether a bar has to be open, and I will ensure that the right hon. Gentleman receives it.
As for community centres—[Interruption.] Sorry, I thought the right hon. Gentleman mentioned social clubs.
No, I just mentioned community centres. Many community centres have facilities for providing food, but do not provide it on some days, for example. On the days when they do not serve food, will people have to wear face masks, or will people be exempt only when they are actually serving food?
Again, a community centre will be run by people who are responsible, and have responsibility for their staff and the people in the community centre. Any community centre would have a policy that people should wear masks. But again, I will get back to the right hon. Gentleman on that particular point.
If a luncheon club is going on and the Minister is saying that people have to wear face masks, it gets down to the point about leaving it to the actual local people to decide. That is not the regulation. It needs clarifying, so they can say, “Fine. If we’re providing food, then people don’t need to. Clearly, if we don’t, or have some other event on and food is not included, then they may have to comply.”
As I said, Mr Efford, I will revert to the right hon. Gentleman with an answer to that particular point.
On the substantive points raised by the hon. Member for Ellesmere Port and Neston, he raised one overarching question a couple of times in his speech, namely why, if we made the guidance on 11 May, we did not introduce it officially until after that date. That is for two reasons. First, the science on wearing masks was evolving, and evidence was coming in from China, Lombardy and other places where masks were being worn, or not, and where studies were taking place on the efficacy of masks in prohibiting the spread of the virus.
Secondly, at the same time, we began to ease restrictions, and as we eased the restrictions we saw an increase in footfall. It was necessary to bring in the regulations because we were easing the restrictions, and the public were coming out on to the streets and into the areas where we were doing so. However, as I have said before, we have seen huge compliance from the public.
The right hon. Member for North Durham did not mention that I was incredibly generous in engaging with him last week on the points that he made about covid marshals. They are out—I was hoping for a nod from the Chair—
I will not take any more interventions, and we will now move on. Covid marshals will be subject to their own SI shortly, but this Committee is about three SIs on face coverings. I will keep to the point of face coverings, which is what I am here to address. I am not here to debate an SI on covid marshals.
I have set out why we felt it necessary to do as we did after the guidance. We were also receiving information that people were happy with wearing face coverings, and, from public compliance and people wanting to keep themselves safe, it was obviously the right thing to do at that time.
I revert to the substantive point: we were constantly easing regulations at the same time as we had issues to do with Leicester. We had areas in the country where rates were rising at the same time as we had national easement. It is very complex, but at the time it was felt that the public had complied and were wearing masks to go into shops and public places. However, we felt it was important, as footfall increased and we had spikes in other parts of the country, that we introduce guidance nationally for people to wear masks.
I will answer some of the shorter points that the hon. Gentleman raised. He asked me how many people had received FPNs: it is eight to date. I am not aware of what fines were charged, and whether they were on the ladder or went up to the full amount, but eight FPNs have issued so far. I was also asked why we are not legislating for handwashing.
(3 years, 11 months ago)
General CommitteesOn the point about covid marshals and data protection, we will get back to my right hon. Friend. A number of points have been made in a holistic and wide-ranging way by different people, and I will try to answer the specifics as much as I can. If I do not cover them all, hon. Members can shout at me; we will certainly ensure that they receive answers by tomorrow.
I will first address some of the wider points about lip reading, because there is some kind of misinterpretation of this. Somebody who has a disability, including deafness, does not have to wear a mask, nor does the person assisting someone. If a deaf person goes up to somebody in a shop and asks for help, the shop worker can remove their mask to provide assistance if they are told, “I can only lip read.” The assistant helping somebody with a disability or helping somebody to find their way—whatever need they have—can remove their mask. I wanted to make that clear.
Reference has been made to the fact that people are not wearing masks in pubs and restaurants, but they are socially distancing. There are hand sanitisers when people enter. As pubs and restaurants are keeping their staff safe, they are being very careful about how their clientele use their premises. I want to reiterate a point that I made in my opening speech: 96% of people wear masks.
On the question of why this took so long and the scientific evidence—a question that has been raised in a number of ways—we as politicians did not decide that it was now time for people to start wearing masks. That information comes to the Government and to politicians via a number of filters. It comes from SAGE. It then goes to the chief medical officer, the deputy chief medical officers—Jenny Harries and Jonathan Van-Tam—and, I think, Professor Stringer, our chief scientific officer. We then take the advice from the Behavioural Insights Team; we take the advice that we are given by the scientists.
The Welsh Government have been mentioned. They have their own chief medical officer and their own advisers. They take their advice; they are devolved. We do not tell them when people in Wales should start wearing masks, and they do not tell us. We have our own established scientific body of advice. We do not say to SAGE, “We don’t like your advice today. We’ll go and take it from somewhere else.” We are consistently advised by SAGE and by NERVTAG. When they tell us that the evidence now is such that people should start wearing masks because there will be some benefits, we will take it. In fact, people were wearing masks before we brought in the legislation. The public had already made their mind up, whether they had the scientific evidence or not, that they would start wearing masks, and indeed they were.
That is where we add. As politicians, we do not say, “Do you know what? It is time for everyone to start wearing masks.” We do not have the authority, the scientific background or the evidence—
No, because every policy dealing with covid has to be based on evidence and scientific facts. We have always followed the science and we are still doing that today.
On the hon. Member’s point about who advises the Welsh Government, I have no idea. I would imagine it is their chief medical officer. On whether the scientists take the decision about whether people wear masks, no, they do not. That is not their responsibility. Their responsibility is to evaluate and assimilate evidence and provide us with that evidence.
I am sorry if the Minister wants to be flippant, but it is my job to look at the legislation and scrutinise it. She said that 96% have no problems with it. I never believe in putting forward legislation if there is no need.
I am sorry, but the Minister is wrong in what she just said. It is down to politicians to make the ultimate decision. I have been a Minister, and there are occasions when advice can be ignored—that is a political decision. It is no good hiding behind the scientists, which is what the Government have done all the way through the crisis.
This is the decision. That is what we are here debating—the decision to introduce the wearing of face coverings in public places. We have taken the decision; that is what we are doing right now.
I was asked why we were so slow to react to the wearing of face masks. It is because, to come here and introduce legislation, we needed evidence that wearing face masks works. As I think the hon. Member for Blackley and Broughton said, this is a new virus—globally, not just for the UK—and all over the world countries have taken their own decisions on the basis of whatever evidence they could gather over a short period and in a short timeframe. We have now got to the point where we believe the evidence is such that wearing a mask will provide protection even if the wearer is asymptomatic, not showing symptoms of coronavirus and not coughing. Therefore, we are introducing the regulations.
We know each other too well.
I want to ensure that what I give the hon. Gentleman is an absolutely accurate statement; therefore, I will give it to him in the morning in writing.
I will stick to the substance of the issues that were raised. On the comments about transport police, the British Transport police outside London have the authority and they use their four Es: engagement, encouragement—
Again, I will clarify that. They might not be in these regulations, but this is about not just Transport for London, but British Transport police across the UK.
On the point about people eating in cafeterias in transport hubs, of course people cannot eat through a mask. When people are purchasing food, or are sitting at a table eating and drinking, they obviously do not have to wear a mask.
I am sorry, but that is not what the regulations say. It is in the definition of what a transport hub is. I will read it again:
“In these Regulations, “transport hub” means any…premises used as a station, terminal, port or other similar premises from or to which a public transport service operates, but does not include…an area which is not open to the public;…an area where seating or tables are made available for the consumption of food and drink”.
Surely a transport hub that has tables for food and drink is not classed as a transport hub under the definition in the regulations.
No, I cannot; I apologise. I will obtain the list of those who have the authority and ensure that the hon. Member for Warwick and Leamington has that tomorrow. The hon. Member for Ellesmere Port and Neston, I am sure, was trying his hand when he asked his question. He did so knowing very well that that is not something that I can commit to.
In this new world of coronavirus and covid-19, we as a Government have to have the right to respond, both urgently and in the case of an emergency, when we need to keep the public safe and to save lives. We have to retain the ability to do that.
The hon. Member for Ellesmere Port and Neston raised one other point that I would like to address. He talked about universities and further education and face coverings. Actually, this has been really interesting, because many universities are very enthusiastic about developing their own policies. They are keen to get their students back in. They are keen to get up and running in a way that is as “back to normal” as it can be in the context of social distancing, and the wearing of a face mask is something that many universities have themselves required. They have done their own messaging to students. I have seen some of this. “Don’t kill your nan” was quite extreme; that was at one university in my own home city. Universities have very much taken on board the fact that they want to keep their campuses safe, and they are launching their own campaigns.
(4 years, 10 months ago)
Commons ChamberMy hon. Friend is absolutely right: it is about breaking down the stigma in mental health. When somebody breaks their leg, they wear a plaster cast and we can see that they have broken their leg. We cannot always see when someone is suffering from a mental health issue, so it needs to be destigmatised. It also needs to be given the same consideration as physical illness, and I think it is.
Obviously, my speech has now been dumped, because so many points were raised in the debate and I feel that I have to answer them. I shall start with the hon. Member for Bath, who raised so many points when introducing the debate. I want to answer some of her questions. One of her first points was about rape crisis centres; this year, we will spend £35 million and fund 47 sexual assault referral centres, to ensure that when sexual violence occurs, there is the best possible response for victims. The centres are available to all victims—male and female, adults, children, and current and non-current victims of rape and abuse.
I want to mention the approach the Government have taken to mental health. I took up this post just as we announced £2.3 billion of expenditure on mental health. Let me put that into perspective: my hon. Friend the Member for Cheltenham (Alex Chalk) informed me that that is more than half the entire yearly prisons budget; that demonstrates how much money we are investing in mental health. The money is going into many areas, but in almost all areas it will have an impact on women and young girls— and this debate is all about women’s mental health. It is important that women are at the centre of all mental health policy. They should be not just be siloed off into their own particular areas; they should be at the centre of everything.
I understand what the Minister says about the increase in budgets, but does she not also realise that cuts in other areas are actually adding to the problems? Therefore, it does not matter how much money we pour into mental health services. Public health funding, for example, which is devolved to local authorities such as Durham, has had a 40% cut, which means that existing services, such as those for substance abuse, have had to be cut. Putting money in one way and taking it out in another does not solve the problem.
The NHS budget is not bottomless, but the mental health budget is growing faster than the overall health budget, and the budget for children and young people is growing even faster than that. One Member—I think it was the hon. Member for Lewisham West and Penge (Ellie Reeves)—said that more people are presenting with mental health issues now than ever before. In fact, GPs agree with that, and say that a lot more people are presenting with those issues at their surgeries. That is due to many, many reasons. One Member raised the issues of the postings on Facebook and Instagram, of body image and of dieting. There are many reasons why people are suffering from mental health issues, and it is not just to do with service cuts, which are being addressed.
I need to race on with my speech because I have just three minutes left. On the maternal six-week check, we hope to ensure that that happens in all our GP contracts going forward.[Official Report, 7 October 2019, Vol. 664, c. 11MC.] The hon. Member for Bath mentioned the Istanbul convention. The Government signed the Istanbul convention in 2012 to reaffirm our strong commitment to tackling violence against women and girls. She also talked about eating disorders—I know that she has brought forward other debates on this issue. She also mentioned body mass index. We want all GPs to adhere to the NICE guidelines, which means that they must take a holistic approach to young women who are presenting with potential eating disorders. I am talking about taking a look at dental records, considering whether those women are still living a full life and still working, whether they are seen to be eating or whether they are absenting themselves after a meal. We need to look at everything in the round. Nobody should be referred for having an eating disorder based on their BMI alone. That is in the guidelines. We are raising awareness of that, and introducing more training for GPs, so that they are aware of this, too. The hon. Lady may be aware that I wrote an article on this subject recently, emphasising that point.
Perinatal mental health, as we discussed, is also important. According to one study published in 2014, a shocking 10% to 20% of women develop a mental health illness during pregnancy, or within the first year of having a baby. From April 2019, new and expectant mums have been able to access specialist perinatal mental health community services in every part of the country.
The NHS long-term plan, which I referred to earlier, commits to ensuring that an additional 24,000 women will have access to specialist perinatal mental healthcare, with more support for fathers and partners. I am pleased to see that NHS England has expanded the capacity of in-patient mother and baby units, which are in-patient services that support women with serious mental health issues, keeping them together with their babies, which is so important.
My hon. Friend the Member for Southend West (Sir David Amess) talked about female offenders. I know that women in prison often have a disproportionately high level of mental health problems, and there are also worrying levels of self-harm. We have recently published standards for healthcare for women in prison and are looking at improving care for pregnant women in prison.
The hon. Member for Lewisham West and Penge talked about health visitors. Earlier this year the Prime Minister announced our commitment to modernise the healthy child programme to reflect the latest evidence on how health visitors and other professionals can support perinatal mental health.
My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) talked about the closure of children’s centres. We are investing £84 million over the next five years to support up to 20 local authorities that are seeing high demand for children’s social care. This will help to support the most vulnerable families, and I am sure that that is welcomed by everyone. It is up to local councils to decide how to organise and pay for services in their areas, as they are best placed to understand local needs.
The right hon. Member for North Durham (Mr Jones) talked about social media and about his constituent trying to get Facebook to take down an advert. I actually congratulated Facebook and Instagram recently on removing all the diet advertisements for miracle cures and diet teas that simply do not work. That is a step in the right direction. I also thank all the women in my constituency who have emailed me on that the issue and others.
I do not have any time; I have only 30 seconds left.
The hon. Member for North Ayrshire and Arran (Patricia Gibson) spoke about poverty. Many of us in this place understand the impact of poverty and have experienced poverty ourselves, and we know that it can cause anxiety not only for women, but for young girls. We absolutely understand those issues.
Let me say to the shadow Minister that our £2 million programme Standing Together Against Domestic Violence looks at how the whole health system can better respond to domestic abuse. Like her, I was delighted that the Domestic Abuse Bill passed its Second Reading yesterday. On carers and increased access, the carers action plan published in 2018 sets out a range of ways that we will improve support for carers. We published a progress review in July this year to ensure that we focus on delivering the plan.
The shadow Minister also spoke about the use of restraint, which is abhorrent. The Government fully supported the Mental Health Units (Use of Force) Bill—a private Member’s Bill that became an Act of Parliament on 1 November 2018. The Act imposes requirements regarding the use of force, the publication of data, and how and when physical, mechanical and chemical force is used, as well as requirements for improved staff training. We want to end restraint. We know that it continues to be a routine occurrence on many wards, affecting women and girls disproportionately. That has to end.[Official Report, 7 October 2019, Vol. 664, c. 12MC.]
I will conclude by stating again that we are putting £2.3 billion into mental health, and that will benefit women and young girls. Never before have any Government ever considered mental health in such a way—with regard to policy, and finance to drive that policy and back it up. I thank the hon. Member for Bath for raising this very important issue. We are making progress, and I am determined that we will make more. I recognise that there is more to do and we will certainly be working on that.
(9 years, 10 months ago)
Commons ChamberI am not going to give way at all.
Anyone would think that every one of my constituents loathed me, but they did not. In fact, hardly any of my constituents signed that petition.
No. The hon. Gentleman has taken up enough time with interventions tonight.
My constituents did not sign that petition because they know the kind of MP that I am. I am not a party-political MP. When I am in my constituency I am not a Conservative MP—I represent everybody, regardless of what political party they vote for, and my constituents know that. They also know that I will go the extra mile. I do not do surgeries once a month—most times I do them every week. My constituents know that I will go the extra mile for them. They know that I do not get involved in grubby political games in Parliament. They know that I represent them. I put my constituency before my party, and I put my constituents before Westminster. I have always done that—
Order. The hon. Gentleman has had a lot to say tonight in interventions, and he should stay in order when the hon. Lady is on her feet.