Covid-19: R Rate and Lockdown Measures

Neil Gray Excerpts

Monday 8th June 2020 Commons Chamber

[Matt Hancock]

That is right. I set out some of the evidence in my statement. It is important that we look at the overall base of evidence and take scientific advice on that. There are 10 models that go into SAGE, and it is important that the media reports the facts, which are that if we take into account all the models, R is below 1 in each region of the country, according to SAGE. Of course, different scientific models will come out with different results, and it is right that the scientists should publish and discuss those—that is how science advances—but it is also important that the media play their part responsibly. I reassure the residents of Burnley and elsewhere in the north-west that our overall assessment is that R is below 1 in the north-west and everywhere else in the country. Of course, we keep it closely monitored at all times.

[Neil Gray (Airdrie and Shotts) (SNP) [V]]

Can the Secretary of State advise whether the R number has been rising or has fallen since the Prime Minister announced, without consultation and with a day’s notice, that people should get back to work in England? Given that some reports suggest that some areas of England have an R number at or close to 1, what consultation has the Secretary of State had with the devolved nations? When will he publish details on what local lockdowns will look like to ensure that the virus is contained?

[Matt Hancock]

I have already answered all those questions. The estimate from the scientists, taking into account all the evidence, is that R is below 1.

[Neil Gray]

indicated dissent.

[Matt Hancock]

The hon. Gentleman may shake his head, but if he asks the same question, he is going to get the same answer.

Covid-19

Neil Gray Excerpts

Tuesday 12th May 2020 Commons Chamber

[Neil Gray (Airdrie and Shotts) (SNP) [V]]

Thank you, Mr Deputy Speaker. I start by paying tribute to all those who are working on the frontline in the battle against this virus. In my area of Airdrie and Shotts, they are the fantastic staff of NHS Lanarkshire, North Lanarkshire Council and other key workers who have been doing the essential work to keep us all safe and well, and also the many wonderful community groups that are doing what they can to help others. I pass on my condolences to all those in Airdrie and Shotts who have lost friends and family to covid-19.

Some of the issues I wish to discuss today have emerged since the lockdown. The first is the impact on people. The UK Government schemes to support individuals, businesses and the self-employed have left millions behind. Millions have had to apply for universal credit, with some who will be encountering the social security system for the first time and who will be facing hardship. The self-employed scheme falls way short and needs to be looked at again. Basing it on profit rather than turnover is a basic flaw in the experience of my constituents.

The furlough scheme needs an independent arbiter for employers unwilling to furlough. Those who had only just started a new job before the lockdown are still being neglected; a contract of employment should have been enough to qualify. There is also a need for the UK Government to provide certainty that they will phase the end of the furlough scheme to ensure there are no redundancies. Where is the help for company directors who take their wages via dividends? This is how so many small family businesses in Airdrie and Shotts derive their income, and it has gone.

The impact the lockdown is having on people’s mental health—for some because they have lost their livelihoods, others because they have lost social contact or because they already had underlying problems—needs much greater attention. The Scottish Government have looked at this, and are increasing funding, but it is a long-term issue that is going to need greater attention.

Staying on the topic of welfare, sadly, the mixed messages of last week and the reckless unpreparedness of the Prime Minister’s announcement the other night— basically, it was to get back to work—have put at risk the relative success of the lockdown in starting to get the virus under control and therefore put lives across the UK at risk. The lockdown has not ended, and the message is still crystal clear in Scotland, Wales and Northern Ireland: stay home, protect the NHS, save lives. However, some people have already been in touch with me to ask if the Prime Minister’s statement means they can do this, that or the other. For how many more has the Prime Minister’s easing of the lockdown and change in message meant a licence to take more risks?

The Prime Minister did all of this without consulting the devolved Governments or, apparently, the Cabinet. This is not a time for making it up as you go along. A crisis like this needs clear, consistent messaging and support packages that ensure that nobody faces hardship. In another world before this lockdown, the Prime Minister promised that nobody would be punished for doing the right thing. Tell that to the millions of people who have been forced on to universal credit or the families in Airdrie and Shotts who are part of the reported 47% increase at the Airdrie food bank.

The UK Government need to do much more listening before doing their talking, and that will be as important in the long term as it is now. Society is going to change, and some changes are already happening. Some are positive and others negative, but there will be opportunities to harness change to deliver a more prosperous society with greater wellbeing. Areas such as the environment, waste and recycling, social security, employment and industry will need radical change and investment. That is for the future, but we need to start thinking now about the good society we want to see emerge. It cannot be what we left behind before the lockdown.

The focus right now has to be on containing and ending the health crisis, but there will be opportunities to make things better when that is resolved. I just worry, after this last week of chaotic and irresponsible mixed messages and anonymous briefings from Downing Street, that it will take longer than it should for us to get to that point.

Acquired Brain Injury

Neil Gray Excerpts

Thursday 6th February 2020 Westminster Hall

[Chris Bryant]

Perhaps we have thought, “Well, a little blow to the head is okay; we don’t mind and we’re not going to worry about that.” The right hon. Gentleman is right; perhaps we have been a bit blasé about it, and perhaps even more so in the armed forces, where people want to show that they are tough and can carry on.

Incidentally, the appearance of symptoms some time later is equally an issue in education. A child might come back to school wearing a bandage, at which point everybody is warm, friendly, loving, caring and supportive. Nine months later, when the bandage is gone and everyone presumes that the child is getting on with their life, the child may start becoming difficult in class, finding it difficult to concentrate and falling asleep in lessons. They may be less in control of their inhibitions, and all the rest of it. The teacher may not recognise that as part of what happened nine months before.

Unless teachers and the whole education system are trained to understand fully the concept of neurocognitive stall, there is a real danger that the child will end up becoming increasingly difficult because they do not know anything else; they get shouted at, which sends them into panic rather than making them say, “Please, Miss or Sir, I need some support and help.” Then the child ends up getting excluded and falling into the criminal justice system. If the support had been sustained from day one for at least a year, and if we had made sure that all the teachers in the school understood those issues, we might have been able to save that person’s education.

[Neil Gray (Airdrie and Shotts) (SNP)]

I commend the hon. Member on bringing this debate to the House, and on the work he has done in this area for some time. He is right to point to some obvious potential ABIs and the lack of knowledge and response. Will he reflect on some areas where there are changes in social norms and ideas about how brain injury can be acquired, such as in the heading of footballs? The Scottish Football Association has considered banning children from heading footballs.

--- Later in debate ---

[Sir Mike Penning (Hemel Hempstead) (Con)]

It is a pleasure to take part in this debate. I campaigned for free car parking with my right hon. Friend the Member for Harlow (Robert Halfon), and I completely agree with what the hon. Member for Mitcham and Morden (Siobhain McDonagh) said about it. Perhaps the Minister cannot commit now to abolishing car parking charges, but I am sure that the Government will do so because we campaigned for that all the way through. No distinction should be made between one type of case and another; people who need to be by their loved one’s bedside should not be paying car parking charges. The NHS was designed to be free at the point of delivery, and that includes car parking for people in that position.

The hon. Member for Rhondda (Chris Bryant) is right in most, if not all, of what he said. His personal experience has given him an outlook that someone like me could not possibly have. Interdepartmental work is the only way to take this forward. Like my right hon. Friend the Member for South Holland and The Deepings, I have been a Minister—in my case, in seven Departments, before I managed to upset the last one and came to the Back Benches. This will only work if the Prime Minister says that there will be an interdepartmental group that will meet regularly and will be chaired by so-and-so—probably the Deputy Prime Minister, as it was then, or the Cabinet Office—and that they will report back what each Department is doing.

As we have heard, nearly every Department will be affected, from the Department for Digital, Culture, Media and Sport—the hon. Member for Airdrie and Shotts (Neil Gray) has alluded to football, and I will declare an interest about rugby and boxing in a moment—to the Department for Work and Pensions, which deals with how personal independence payment is assessed, and where I used to be a Minister. As I said earlier, because of the nature of the injury, it is not always visible; very often, it is inside.

I will touch on some other points. I understand exactly where the Scottish Football Association is going in looking at the issue of younger people and heading, but if those young people go on to play professional football later, they will head the ball. The rest of the world of football must take a leaf out of rugby’s book—particularly rugby union. I declare an interest: I stupidly started playing rugby when I was 11, and I am still playing now. I will be playing against the Welsh Assembly at Richmond in a couple of weeks’ time; that game might be slightly more interesting than the England-France one was.

Perhaps because we have seen some shocking injuries and we know what is going on, the game has changed, not just in that we now pull people off the pitch to be assessed, but in how we tackle. To be fair, a lot of that has to do with American football, where they used to lead with their head because they had the protection of the helmet, and because of machismo. Women’s rugby is the fastest-growing female contact sport in the country, and it has been for years; quite right, because it is brilliant to watch. However, in women’s rugby as well as men’s rugby, the game had to change to protect the players—those going into the tackles as much as those coming out of them.

[Neil Gray]

Like the right hon. Gentleman, I declare an interest in view of my past, rather diminished career as a rugby player. Football certainly has a lot to learn from rugby, not least when it comes to what he is saying about the contact area. The enforced absence of a player from the pitch for a period of time following a concussion diagnosis is also important, and it is something that football needs to learn from.

[Sir Mike Penning]

I could not agree more, and I was just coming on to that point. The Football Association and FIFA do not need to reinvent the wheel. We need to take time to assess whether a person has been concussed and, if so, they should not play the following week or the week after that. Those assessments have to be done by professionals, away from the pitch, and sometimes with scans.

Rugby has led the way. I watched a rugby league match this weekend—I have a rugby league team in my constituency, even though I am deeply in the south. Some of the tackles just would not be allowed in rugby union any more. As far as I could work out, they were old-fashioned spear tackles—the player is allegedly going for the ball, but they catch their opponent around the top of the neck, and that causes damage to the brain, which rattles around inside the piece of bone that protects the brain. It is plainly obvious that we needed to change, and it has taken time—probably too long—but it has happened.

Boxing also has to change for the better. I declare an interest, in that I boxed for many years. I am talking not just about the terrible things have gone on in the ring, as a result of which people have died for a sport that they love and want to be involved in, but about what happens to people years later. I will not name names, but I know several former world boxing champions who now suffer the consequences of the brain damage that they incurred. They can be read about in the papers. I do not need to name them, and it would be improper to do so.

This is not just about concussion. People in this situation have gone through clinical depression, and their injuries affect them and their loved ones for the rest of their lives. We must support more awareness and encourage the sport to do all it can to open up. We do not need to reinvent the wheel, but we must learn from other sports. I wish the hon. Member for Airdrie and Shotts luck in Scotland on Saturday, and I hope that England play somewhat better than they did against France. Let us hope that there are no injuries like some of the ones we have seen in the last couple of weeks. There was a neck and spinal injury at the Saracens-Worcester game the other week, and it was spine-chillingly horrible. People want to play the sport and it is their passion—stupidly, I still play—but we have to make sure that we protect them.

I want to touch on long-term care and the assessments that are carried out when people with a pre-existing brain injury of some description get dementia. Continuing healthcare is an absolute minefield. I have heard about this from too many of my constituents, and from colleagues in the House over the years. Even though someone who is going into care has a medical condition—a brain injury—before dementia comes on, that seems to be put to one side when the panel look at continuing health provision for them. That is fundamentally wrong.

Just because someone develops dementia or Alzheimer’s, it does not mean that their other medical conditions have vanished off the face of the earth. They have not. But time after time, I have had to help individuals and their families to go to appeals and tribunals to get something that they would probably have got if the individual had not got dementia, but that that they do not get because they have dementia alongside the pre-existing injury. It sounds very complicated, but it is actually very simple. If someone has a medical condition, such as a brain injury, that brings on dementia—we do not really understand that, and I was reading some research last night on the reasons for it—surely, the medical and nursing care that they needed for that brain injury should not be put to one side when they go for an assessment if they have Alzheimer’s or dementia.

I give praise where praise is due. I was a shadow Health Minister for four and a half years when the last Labour Government were in power, and they started the major trauma centres. The debate started with them, and they progressed it. The issues with major trauma centres are about where they should be, how quickly people can get to them and whether enough people are using them to make them viable, given the required expertise. To be honest, it is the same old story as with A&Es. Major trauma centres are not A&Es; they are specialist units for people who need specialist care. People who need to go to A&E should go to A&E, and people who need to go to a minor injuries unit should go to a minor injuries unit. It is about making sure that people go to the right place.

With major trauma, the decision is made for people. All the major trauma centres have helipads now. I truly hope that as they develop as centres of expertise, we will recognise that people need travel to the right place to see the specific consultant specialist who can save their life. That may not be the centre that is just down the road or the one in London—for my constituents, such things often involve coming into London—but it might be one that is 20 minutes away by helicopter ride. That is absolutely right, if that is where the expertise is. The time when people need to be closer to home, and to the support of their loved ones, is when they come out of major trauma centres and into rehabilitation.

Public understanding about major injuries is better these days. I was a fireman for many years and, sadly, I went to too many road traffic incidents. People are increasingly surviving major road traffic incidents or collisions. We tend not to call them accidents these days, because they are not accidents—they are preventable—and victims feel very strongly that we should not call them accidents. I understand that view. I made a big booboo as road traffic Minister when I talked about road traffic accidents. I did so because that is what firefighters did, but I respect the point: every accident is preventable, and these are collisions in which people’s loved ones are involved.

Today’s survival rate has a lot to do with the manufacture of the vehicles, airbags and how crush plates work inside vehicles. Those things mean that more people are surviving, but with very serious injuries. As I alluded to in my intervention, some of those injuries are physical and show themselves there and then, but a lot do not show signs until much later—sometimes nine weeks or nine months, or sometimes many years later.

That brings me to my final point, which is about our armed forces. We send our armed forces around the world. They work in a very dangerous occupation, and we try to make it as safe as possible. Sometimes, there are injuries in training. We sadly lost one of our Royal Marines only the other day; he was doing the job he loved and training to do something he was passionate about. Our thoughts and prayers are with his family, friends and loved ones.

We must look after our armed forces personnel after they are injured. I can remember so many incidents around head injuries when I was a squaddie, and there was no way that I would have gone down to the medical officer the day after a head injury with a headache. The barrack room humour would have been all about, “Get on with it. You are supposed to be robust.” I have been the Minister for the Armed Forces, and I think we are getting there, but the way forward is to improve public awareness. That involves debates such as this, and perhaps an overall Government body that can look at the issue in general terms. I hope we do not need too many of these debates—I have been around a long time—before we get to a better position in Government.

[Neil Gray (Airdrie and Shotts) (SNP)]

It is a pleasure to contribute to this debate on behalf of the SNP with you in the Chair, Mr Robertson. I strongly commend the hon. Member for Rhondda (Chris Bryant) for bringing the debate to the House, for his contribution over many years and for the erudite and informed way he goes about his business on this subject. I hope it means that ears are open to what he has to say, not least today. He has certainly earned respect for his erudite contribution in the debate today. I am only sorry that the debate is happening on a Thursday—normally a day when colleagues take time in their constituencies to carry out constituency business, which is why so few are here with us today.

The speeches today have been consensual in nature and informed and have added a very real quality to the debate, which I am sure the Minister will reflect on as she comes to sum up. The contribution of the hon. Member for Rhondda was very personal. He rightly mentioned the report of the all-party parliamentary group that he chairs, whose publication my party welcomed. He drew on examples of people he has worked with who require and deserve specialist provision as close to their home as possible. All Governments in these isles need to reflect on that, and on the wider societal impacts of ABI, which require earlier and greater intervention to prevent them from happening at all. The hon. Gentleman was also right to raise the issue of language in this context; he himself cited an unfortunate example and I hope that we will all reflect on it in the future.

The right hon. Member for South Holland and The Deepings (Sir John Hayes) too made a very erudite contribution, which was also informed by his personal experience, and I commend him for the work that he has done with the all-party parliamentary group, too. And he was right about the need for cross-departmental and cross-Government co-ordination, which I will come on to later in my speech.

I commend the hon. Member for Mitcham and Morden (Siobhain McDonagh) for her work with Headway. The point about a brain injury ID card was a very interesting focus of her speech. The benefits of such a card, which she articulated, are quite clear.

Like other colleagues, not least the right hon. Member for Hemel Hempstead (Sir Mike Penning), who have campaigned strongly on hospital parking charges, I am sure that the hon. Lady will be aware that in Scotland we have already got rid of them. I encourage them to keep pressing the Government in that regard, because of the very obvious benefits that such a change would provide for people using hospitals.

The right hon. Gentleman was right to focus on sport; our exchange on that subject is on the record. I entirely agree with him that sport undoubtedly has a role to play and can do immeasurable good for society, not only in terms of physical health but in terms of mental health. However, a lot of work needs to be done, especially in the particular sports that he mentioned but also in sport generally. The hon. Member for Rhondda rightly highlighted that issue as well.

As for myself, I will relate the Scottish experience. Be it in relation to ABI or any other issue, disabled people—regardless of their condition—deserve the right to live as independently as possible, and they should have freedom, dignity, choice and control over their lives. Accessibility is at the foundation of the approach that the Scottish Government are taking in providing disability support. I point Members towards “A Fairer Scotland for Disabled People”, which is the Scottish Government’s plan in response to the UN convention on the rights of persons with disabilities. It aims to make equality of opportunity, access to services and independent living a reality for all disabled people, as well as being a national plan for accessible travel, an awareness-raising campaign about the barriers that disabled people face, and a review of the legislation regarding adults with incapacity. It also aims to increase the uptake of modern apprenticeships by disabled people, to provide a new social security system that treats people with these conditions with dignity and respect, and to call for more work to tackle disability hate crime and violence against disabled women and girls. The Scottish party’s vision is that children and adults in Scotland with acquired brain injury should have equal access to the highest quality brain injury care, regardless of where they live.

The Scottish Acquired Brain Injury Network was established in 2007, with the key objective of enabling improvements in access to and the quality of services in Scotland. SABIN comprises service user representatives, healthcare professionals, service providers and voluntary sector groups, and it has published the traumatic brain injury and adult standards. Those standards have ensured that there is a joined-up approach to immediate and long-term care for people with an acquired brain injury. The right hon. Member for South Holland and The Deepings raised that earlier, and the Government here in Westminster should look at.

The Scottish Government have also made significant investment in the health service to provide the care that is required, including opening two major trauma centres in Dundee and Aberdeen, with further centres due in Glasgow and Edinburgh soon. I hope that all these centres will be adequately staffed with neurorehabilitation consultants, as the hon. Member for Rhondda suggested.

Clearly, there is work to do, not just in Scotland but elsewhere in the UK. Nevertheless, I hope that colleagues will recognise that Scotland is working hard on this issue. I thank the hon. Gentleman once again for bringing this debate to the House. I hope that his demands are taken seriously, and that that is reflected in the Minister’s response to this debate.

--- Later in debate ---

[Caroline Dinenage]

Thank you; that is a very generous offer. People can see what an inspiring group Headway is.

We have heard a lot about the excellent and wide-ranging APPG report from 2018. As the hon. Member for Rhondda said, the Department of Health and Social Care co-ordinated with officials from across Whitehall to deliver the response, which was a truly cross-Government response, but I certainly feel his frustration at how silo working across Whitehall can be an impediment to getting the change that he wants. A number of right hon. and hon. Members have mentioned that today, and I will certainly take forward the idea of a real, collaborative cross-Whitehall group to discuss this. Even from the issues raised today, the Department of Health and Social Care, the Department for Work and Pensions, the Department for Digital, Culture, Media and Sport, the Department for Transport, the Department for Education, the Ministry of Defence and the Cabinet Office—I am sure there will be others—all need to be involved in the conversation.

[Neil Gray]

I thank the Minister for her contribution thus far. It was remiss of me, not just as someone who comes from an armed forces family but as a constituency MP with cases involving constituents who have been medically discharged from the armed forces, not to highlight and focus on the contribution from the right hon. Member for Hemel Hempstead (Sir Mike Penning) on the greater work that needs to be done within the MOD and across Government to ensure that we are treating our armed forces personnel, particularly when they leave service, with greater respect, and to ensure that we are providing for them, given the level of service that they have provided to all of us.

[Caroline Dinenage]

The hon. Gentleman is absolutely right to raise that issue. NHS England has a veterans trauma network, which delivers comprehensive medical care to veterans, including those suffering from brain trauma. It does excellent work, but there are also many individual charities up and down the country that work to support veterans who may not have been diagnosed; they may have been diagnosed with post-traumatic stress disorder or something else, but never actually had the original head injury diagnosed.

Almost as if to highlight the fact that this is a hugely cross-Government issue and the inadequacy of Ministers working in their individual silos, I will today be able to focus massively only on the issues relevant to our health service, but I will try to come on to a lot of the questions that right hon. and hon. Members asked.

NHS Funding Bill

Neil Gray Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Patrick Grady]

Yes; I absolutely agree. My hon. Friend is right: I barely noticed the difference as this place magically transformed itself into the Legislative Grand Committee (England). Incidentally, I do not know whether he remembers, from his time here, whether the Scottish Grand Committee was ever permitted to meet in the Chamber of the House of Commons. I fear it was not, so quite why the English Grand Committee enjoys that privilege and does not have to meet elsewhere in the building or elsewhere in England is kind of beyond me. But my hon. Friend is right that those of us from seats in Scotland and Wales and Northern Ireland are, for the first time, being actively excluded from the opportunity to vote on amendments.

The right hon. Member for Alyn and Deeside (Mark Tami) may also have been a member of the Procedure Committee back in the day; I certainly seem to remember points about the cross-border hospitals being raised. He has constituents in Wales who use hospitals in England that will be affected by this legislation, and he is unable to vote on or amend those provisions.

[Neil Gray (Airdrie and Shotts) (SNP)]

My hon. Friend’s secondment to the English Parliament is going rather well so far, although it is rather similar to the UK one. Does it not distil the ridiculousness of the EVEL procedure that we have before us a Bill that clearly impacts on the funding of the NHS in Scotland, as the former Secretary of State mentioned, and yet the Government have put the Chair in the invidious position of deciding on the issues that we can or cannot vote on, instead of our making that decision about the issues that are important to our constituents?

[Patrick Grady]

My hon. Friend is absolutely right; and we raised those points five years ago, when the EVEL process was being introduced.

Tessa Jowell Brain Cancer Mission

Neil Gray Excerpts

Monday 13th May 2019 Commons Chamber

[Matt Hancock]

My hon. Friend is a former colleague and dependable Minister, and I regret not having mentioned the work that he did in my opening remarks. The hon. Member for Leicester South said that he and my predecessor as Secretary of State had worked together on this issue, but the person who did the hard yards was my hon. Friend, and I pay tribute to him.

My hon. Friend is completely right: it is not just about surviving cancer, but about living well both with and after it. We must make sure that we learn that lesson and put the needs of patients at the heart of the process—not only their medical needs, but their non-medical and social needs. One of the humorous and amusing things that Tessa would talk about was the importance of the shape of the wig and the colour of the headscarf to a person who is going through chemotherapy, and that should be at the heart of treatment.

[Neil Gray (Airdrie and Shotts) (SNP)]

I welcome the statement, and thank the Secretary of State for giving me advance sight of it. I join Members on both sides of the House in remembering Dame Tessa Jowell, her lifetime of public service and, of course, her brave campaigning during the final months of her life.

This research funding is very welcome, and it was good to see Edinburgh University’s Dr Steven Pollard involved with the Tessa Jowell mission. Will the Secretary of State expand on what he said about research spending being UK-wide, and on the implications of that? Will he also say something about how his Department has worked with the Scottish Government in this important area?

I am sure that the Secretary of State is aware of the statement made this morning by Medac, which manufactures the “pink drink”, and its concerns about medical supplies post Brexit. Will he update the House on the work that he is doing to ensure the smooth continuing supply of that very important medicine?

[Matt Hancock]

It shows the power of bringing people together that we can agree with the Scottish National party’s Front Bencher on the importance of this agenda. I am delighted that the research spans the whole UK. The National Institute for Health Care Reform is reserved, and health research takes place throughout the country, and indeed internationally—throughout Europe and the world as a whole. Much of the best research is global, and that must continue. I shall be happy to work with colleagues in the SNP Government to further this mission and this end. Innovations of this kind are of course available to the NHS in Scotland, but the decision on whether to roll them out there will be a matter for Scottish Ministers, as that element is devolved.

As for the question of Brexit, I have absolutely no doubt that whatever form Brexit takes, we will do everything we can to ensure the continued and unhindered flow of medicines. We did an enormous amount of work to ensure that was the case ahead of 29 March. I have seen the comments the hon. Gentleman mentions from the company that supplies this drug. I see absolutely no reason to think that Brexit should have any impact at all on the ability to use this cutting-edge drug to save people’s lives.

Clinical Waste Incineration

Neil Gray Excerpts

Tuesday 16th October 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend is right to identify the concern there has been following comments on social media and certain media reports about incineration and the nature of this clinical waste. As I said in my statement, I am happy to confirm that there is sufficient capacity, as Mitie has demonstrated. It is worth reminding the House that just 1.1% of the waste under discussion is anatomical, and many of the media reports do not reflect that.

[Neil Gray (Airdrie and Shotts) (SNP)]

The business concerned, Healthcare Environmental, is based in Shotts in my constituency. Waste incineration—where and how it happens—is always an emotive and controversial issue, and it is imperative that we get strong regulation right. But it appears that the UK Government have influenced—shall we say?—that regulation to deal with an issue that the company claims was contained and it had a plan to deal with.

Can the Minister confirm whether special dispensation has been granted to a municipal site in Slough that apparently does not have a licence to deal with hazardous waste, to incinerate this waste in a way that would otherwise have been inappropriate? Can he confirm that the waste has been handled by unlicensed individuals and been moved against normal regulations? Can he clarify what role the Cabinet Office has had in this issue and whether the UK Government have had any relationship with Healthcare Environmental’s competitor, Stericycle? The focus last week was on Healthcare Environmental, and now the focus appears to turn to Government actions. With 400 jobs under threat across the UK and 150 in my constituency, is it not time we had an independent inquiry into this whole mess?

[Stephen Barclay]

The hon. Gentleman is right to recognise that there is a significant impact in Scotland, given the services that HES supplies, and it is worth reminding the House that HES is still trading and clearing waste from a number of NHS sites. However, given that it has been subject to a series of actions by the Environment Agency and is subject to a criminal investigation, it is worth treating HES’s claims with a degree of caution.

The Environment Agency is of course an independent agency, so it is for the Environment Agency to look at how waste is being processed, and a strict legal framework applies to that. The specific concern about Slough has not been raised with me, but I am happy to take that away and write to the hon. Gentleman.

The Cabinet Office has been in active discussion with the NHS and the Department of Health and Social Care, as have Scottish officials, who have worked very constructively with officials in England. This has been seen as an issue that affects Scotland as well as England, and it is one on which officials have worked collaboratively.

Phenylketonuria: Treatment and Support

Neil Gray Excerpts

Tuesday 26th June 2018 Westminster Hall

[Liz Twist]

My hon. Friend is right, and I want to touch on that issue.

As well as having to have bread specially baked with prescribed flour, people with PKU can have no cheese, eggs or dairy products. Even some vegetables, such as cauliflower, are problematic, and so are potatoes, so there can be no chips or crisps. The daily intake of food needs to be monitored constantly. Imagine how that must be for a child at school who just wants to join in with classmates, or for young people who want to go out and socialise with friends—perhaps to go for a pizza, as my hon. Friend mentioned—and get on with their life. Everything must be measured and calculated to make sure that the appropriate level of protein for the child or adult with PKU is not exceeded.

Let us not forget that the condition is lifelong, and adults, too, must restrict their intake of protein. On top of all that I have described, both children and adults must take a protein supplement. I and other MPs have had the chance to try it, courtesy of our friends at the NSPKU, and it is not a pleasant experience. That puts additional pressure on parents, who often struggle to get their children to take the supplements, which they really need, three times a day. Making sure a child has the right diet, including when parents are not around to control it, and trying to make food interesting, often by starting from scratch with basic low-protein foods, is a minefield.

[Neil Gray (Airdrie and Shotts) (SNP)]

I congratulate the hon. Lady on securing the debate and on her work for the all-party group. A constituent shared with me some experiences similar to the ones that she has outlined. They are heartbreaking, and other Members who have constituents with PKU will share that feeling. Does the hon. Lady agree that alongside the medicinal treatments that might be available, it is important to raise awareness, through debates such as this one, and through Thursday’s “diet for a day”, in order to help provide and incentivise more support for parents who are supporting their children with PKU?

[Liz Twist]

I agree; it is important to look at the question in the round.

Many parents find that they need to give up work or reduce their hours to maintain their child’s diet and keep them healthy. At the end of last year, the NSPKU produced a booklet and video, “Patient Voices: Listening to the experience of people living with PKU”, which clearly and movingly sets out the practical and psychological impact of the condition on individuals.

NHS 70th Anniversary

Neil Gray Excerpts

Wednesday 16th May 2018 Westminster Hall

[Nick Smith]

My hon. Friend makes an important point. As always, she is ahead of the game—I will come on to that point shortly.

Obesity is the second biggest preventable cause of cancer. Diabetes leads to significant complications, including, in extreme cases, amputation. The consequences for our society are massive. NHS England has said that around £16 billion a year is spent on the direct medical costs of diabetes and conditions related to being overweight or obese. That is more than the cost of delivering all our countries’ police and fire services combined. The Government cannot shirk their responsibility to tackle the issue head on. When the next chapter of their childhood obesity plan comes into effect, it needs an effective UK-wide public health drive. It needs to do more to deal with that priority. The 2015 Conservative manifesto pledge to clamp down on advertising unhealthy brands vanished into thin air by the time of the first childhood obesity plan.

It now looks like junk food ads may be banned from programmes where three quarters of the viewers are children. That is to be applauded. It is a good thing, but it fails to tackle the big primetime shows that families gather around the sofa for: shows such as “The X Factors” and the aptly named “Saturday Night Takeaway”. That is without mentioning, with the World cup on the horizon, the premium advertising space around sport. There is a real contradiction when fantastic displays of athletic prowess are bookended by burgers and packaged with pizzas.

Alongside others, Cancer Research UK is pushing for a 9 o’clock watershed for junk food adverts, and the Government must consider that proposal seriously. It is not only me who thinks that; the head of the NHS, Simon Stevens, thinks it would be a good way to tackle this scourge. He believes that even the likes of Facebook must be roped into any plans that limit junk food advertising. The Jamie Oliver Food Foundation suggests having mandatory training for GPs and health professionals to talk about weight in a helpful way and to refer patients to nutritional experts. Whatever the Government decide, they will need to be bold in the face of pressure from the industry heavyweights and their lobbying teams. When plans emerge from this Government, every organisation should be doing their bit.

I was pleased to see the Mayor of London, Sadiq Khan, take real steps to address junk food advertising last week with his announcement that such adverts are to be banned from the tube and bus networks. Almost 40% of London’s 10 and 11-year-olds are obese or overweight. The Mayor is taking a positive step to tackle what he has rightly called “a ticking time bomb”, and that must be supported. However, it is up to all public bodies, including devolved Administrations, councils and housing associations, to weigh in. Primary schools should promote walking every day to their pupils. It is about using soft power and nudge, as well as improved regulation to make legislative and cultural change.

[Neil Gray (Airdrie and Shotts) (SNP)]

The hon. Gentleman is talking about action to tackle childhood obesity and junk food adverts, and also about Jamie Oliver. He will perhaps be aware that Jamie Oliver met the First Minister of Scotland on Monday and welcomed and supported the Scottish Government’s plan to halve childhood obesity by 2030. Would he care to welcome that, as Jamie Oliver did?

[Nick Smith]

I am pleased to welcome that support for a UK issue that we all need to work on.

With further support, we could achieve the healthy lifestyles that so many people want by using influence and our voices. I want to round this speech off with one initiative that I think deserves real backing. It will help our society get on track to healthier lifestyles. To return to Bevan, the initiative is about harnessing community support to deliver improved health for all. Dame Kelly Holmes teamed up with the NHS and parkrun last weekend to encourage people to “take care of yourself” in the build-up to a special parkrun for the NHS on 9 June. My local parkrun group is the Parc Bryn Bach running club, and I can report what a difference such initiatives can make. After a year of running every week, my blood pressure is down and I have tightened my belt a few notches.

I am grateful for the esprit de corps of my local running club. Parc Bryn Bach has Saturday parkruns, special Sunday sessions for parkrun juniors and is a backer of the brilliant NHS Couch to 5k scheme. Just a few Mondays ago, it had 150 people running through a wet, windy April evening to get their fitness up. Over three months, many of those local people will gain confidence and a level of fitness to help them change their lifestyle. The camaraderie and support on offer is fantastic, and that is what makes these schemes fun to join and easy to keep up. Unsurprisingly, the club membership has doubled in recent years, and the coaches and volunteers include many health professionals. They are a great team. I am pleased that the Welsh Labour Government have seen the value of that. Welsh Athletics is supporting clubs with regional Couch to 5k programmes.

--- Later in debate ---

[Neil Gray (Airdrie and Shotts) (SNP)]

It is a sincere and genuine pleasure to serve under your chairmanship, Mr Hosie. I pay tribute to the hon. Member for Blaenau Gwent (Nick Smith) for securing this debate and for his thorough and measured speech. He talked about the challenges we face in the NHS, about austerity—obviously, across these isles, we all face the challenge of dealing with austerity constraints—and about obesity. I mentioned earlier that on Monday, Jamie Oliver met the First Minister of Scotland, Nicola Sturgeon, here in London. He backed the Scottish Government’s target to halve childhood obesity rates by 2030 with a new healthy weight and diet plan, which is due to be published this summer. It will include action to restrict promotions that advertise junk food, including multi-buy deals on unhealthy products.

The hon. Gentleman mentioned the fantastic parkrun, which is one of the best lifestyle movements—if you will pardon the pun, Mr Hosie—that we have. It is free, run by volunteers and accessible. It is 5 km—anyone of any ability can manage that. This morning, I managed to get some miles in the bank before this debate, alongside my Scottish National party running club colleagues. The hon. Gentleman is more than welcome to join us any time he wishes. The invitation is open to all: we are ecumenical.

The hon. Member for Ayr, Carrick and Cumnock (Bill Grant) gave us a very good history lesson about how far the NHS has come. He was very comradely in his cross-party acknowledgment that Labour founded the NHS, and rightly so. In his comradeliness, he neglected to mention any of the NHS measures in Scotland, which are no doubt helped in no small part by the intervention and support of his daughters. It is right that we pay tribute to NHS workers. The NHS in Scotland is the best performing in the UK.

My constituency neighbour, the hon. Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney), perhaps missed the tone a wee bit, but I understand his anxiety. He talked about Monklands Hospital, which is in my constituency. Of course, the SNP Scottish Government have committed funding to build a new Monklands Hospital. We are all aware of the challenges previous Scottish Governments faced with the accident and emergency service at Monklands Hospital. There was potential for a downgrade, but the hospital’s future is secure and we are going to get a new service. The hon. Gentleman talked about funding, and of course the NHS in Scotland is supported by record funding levels. However, the hon. Gentleman is right that, like all NHS services, we are not without our challenges in Scotland. In that regard, I hope that he pursues the case that he mentioned, involving his mother. It is right that where there are problems they are called out and we learn from them.

The hon. Member for Henley (John Howell) talked about the need for a long-term plan for the NHS. We all agree with that. He also talked about care not being properly integrated, but in Scotland we have legislated to integrate health and social care, so we are further down the road to seeing it realised. He was right to mention that public health must be central—we must all remember that, and remind ourselves of it.

The hon. Member for York Central (Rachael Maskell) was right to pay tribute to Dame Tessa Jowell, who personified dignity, passion and eruditeness in her final months of campaigning on health issues. We all pay tribute to her work and pass on our sincere condolences to her family.

The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) gave a very measured speech based on experience and personal testimony. He is right that the NHS is fundamentally about fairness, and he was right to pay tribute to our NHS staff, as we should all do—it should be something to unify us all. He talked about rurality and distance, and I benefit from experience in that regard because I am originally from Orkney, so I well appreciate the challenges of local service delivery, which are not too dissimilar from the ones that he faces in his constituency. I know, however, that the Scottish Government are aware of that and that the door is open to him should he seek to make representations or come up with ideas.

The hon. Gentleman also spoke about the potential for UK conversations, but as I have said, the Scottish health service is performing well according to any number of measures. The issues and conversations that we are having are about funding, and about breaking the austerity stranglehold that affects all our local public services. Perhaps he will join us in continuing to challenge UK Ministers to end austerity.

The hon. Member for Bristol South (Karin Smyth), too, gave a very good speech based on experience. She spoke about the new challenges that we face and how they have changed over time. She mentioned obesity, as I have, and alcohol abuse. The Scottish Government have intervened to legislate for and bring in, after much challenge, a minimum unit price for alcohol in Scotland. UK Ministers are following developments to see how progress is made. When discussing NHS staff, it is right to mention frontline staff—our nurses and doctors—but we should also mention the decision makers, leaders and management level. I have a good working relationship with my local decision makers and managers, and the hon. Lady was right to mention them.

I want to touch a wee bit on my personal experience of the NHS. In many ways, it has shaped where I am, and I am personally indebted to it. First, when I was a young boy, not that much older than my son is now, I pulled a kettle of boiling water down on myself. The scars are still there on my arm and chest, a physical reminder of what happened. Had it not been for swift and expert intervention at the time I would not have the full use of my right arm, so I am personally indebted to the staff in Kirkwall and Aberdeen for what they did for me.

Those who know me and my slightly accident-prone nature will be surprised to learn that my next major intervention from the NHS was not for 20 years, when I dislocated my knee running on a running track, ending what little there was of my athletics career. However, it could have been far worse. Had it not been for the swift intervention of the surgeon at Ninewells Hospital, John Dearing, who operated within the week, because of the nerve damage I sustained when I dislocated my knee I would not have the full range of mobility in my legs that I have now. As I have said, I can still run, and play football and rugby equally badly, but I would not have been able to had it not been for his swift and timely intervention, so I am very grateful.

I am sure that many of us in the House are indebted to the NHS in one area that we have not really talked about, other than the hon. Member for Caithness, Sutherland and Easter Ross. I am certainly grateful to the NHS for the wonderful experience of the birth of my two children. Sometimes we take such services for granted, in particular when we hear about the experience of friends in America, for example. Anecdotally, if we make an analogy with the recent delivery of the royal baby in the Lindo wing, American patients could travel first-class the whole way to the Lindo wing for the same price that it would cost to have their baby delivered in America. We should all remind ourselves of how fortunate we are in many regards in this country.

I know that we do not all have positive experiences when we interact with the NHS. I deal with complaints about the NHS, just as any MP, any Member of the Scottish Parliament up the road, or any colleagues of the hon. Member for Blaenau Gwent in Wales do. However, as I mull over developments in my area, such as the new Monklands Hospital, and the medical advances that have been made over the past 70 years, we should be incredibly proud of our NHS and protect its integrity with every political and moral fibre available to us. I thank all those who work in our NHS, past and present, in Scotland and across these isles, and I wish the institution that we are so proud of a very happy 70th birthday.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

What an interesting debate. I echo the view of the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), that it is a privilege to be in this position at this time in the NHS’s history. I feel like I know her Aunty Ella personally—what a lovely family anecdote that was. That real example was a good reminder of what the NHS has brought to families.

I congratulate the hon. Member for Blaenau Gwent (Nick Smith) on securing the debate. Those who know me know that I certainly share his passion for this topic. Winchester cannot claim ownership of Mr Bevan, but Florence Nightingale established a hospital in my city on the hill—the Royal Hampshire County Hospital, which is much loved and is still there doing great things. It has very committed and caring staff. The hon. Member for Bristol South (Karin Smyth) said that the NHS was a great achievement but that there were also a number of compromises. If I may say so, she was very astute to put it that way. As many Members have said, we live with that achievement but there are many compromises.

The NHS is of course 70 years old this year. Much has changed in our society and our health since 1948. Our health needs are very different, and we have better drugs and diagnostic tools. When the NHS was born, life expectancy was 66 for men and 71 for women; today it is 79 and 83 respectively. That is incredible. In 1948 there were more than 34 deaths for every 1,000 live births; today there are just five, although that is still too many.

I will start where every Health Minister should, by thanking our NHS staff for all they do, day in, day out, to make our NHS something that we are incredibly proud of. There was a great awards event this week in London, at which the Duke of Cambridge spoke, which showcased so many wonderful examples. Indeed, Mr Bevan would be amazed at the work that goes on today across the NHS.

We want to use the NHS70 moment to reflect on the last 70 years of patient care, to celebrate the innovations in the NHS, to raise awareness of the many ways we can support the system and, probably most importantly, to promote the public’s role in the future of the NHS and the importance of taking care of our own health and using the NHS wisely—and, yes, accountability, which the hon. Member for Bristol South wisely raised. I am giving her a lot of credit. [Interruption.] “Keep going,” she says.

So much of this debate is about our changing society, but the NHS has consistently been a universal service that is free at the point of need. That will continue. However, as several Members said, we are facing many different challenges from those we faced back in the ’40s, such as the prevalence of type 2 diabetes, which my hon. Friend the Member for Henley (John Howell) mentioned. He sits on the all-party parliamentary group on diabetes. I was bitterly disappointed that he did not give us any of his medical updates, but I know that those will come another time. In fact, we heard a couple of medical examples from the SNP spokesman, the hon. Member for Airdrie and Shotts (Neil Gray). The rising prevalence of type 2 diabetes is a great challenge for us, as is cancer. Both can be reduced if we tackle obesity and encourage more people to lead healthier lifestyles, so that is where I will focus.

The Government take the public health challenge we face incredibly seriously. We have responded by putting prevention at the heart of public policy making. We have taken quite stringent steps. As the shadow Minister said, we are a global leader on tobacco control. We were the first country in Europe to introduce legislation to bring in plain packaging for cigarettes, off the back of the smoking ban in public places. She rightly mentioned Fresh North East, which is a very good example—it is in many ways the apple of my eye in this policy area. I hope at some point, if the arithmetic in this place ever allows, to go and see it for myself. I will let her know if I do—perhaps we can do that together. In April we introduced the soft drinks industry levy, which is a big public health measure. In recent years we have vaccinated more than 1 million infants against meningitis and an additional 2 million children against flu.

We have run award-winning public health campaigns, including Be Clear on Cancer, which I am very invested in, and Act FAST, the public health stroke campaign. They all sit with the inheritance of the landmark Don’t Die of Ignorance campaign about the AIDS challenge we faced in the late 1980s—I am surprised that was not mentioned. That campaign still makes the hair on the back of the neck stand up, does it not? It was an incredibly impactful and powerful piece of work that came out of the public health movement.

I want to cover a lot of things, but let me return to diabetes, which is a major challenge. Preventing diabetes is a huge priority for the Government. According to Diabetes UK, which I saw just last week, about 5 million people in our country are currently at high risk of developing type 2 diabetes. If the current trend persists, one in three people will be obese by 2034 and one in 10 will develop type 2 diabetes. Some of the risk factors for type 2 diabetes, such as poor diet and a sedentary lifestyle, which can lead to obesity, can be changed. We know that 61.4% of adults are either overweight or obese; and 26% of adults and 20% of children aged 10 to 11 are obese. The obesity crisis has been decades in the making, and tackling it is a real challenge. It will not be turned around overnight, and no one pretends that it can be. That is why tackling obesity is absolutely a Government priority. I will come back to that point in a moment.

I mentioned the NHS diabetes prevention programme, which is aimed at providing people aged 40 to 60 who are at risk of diabetes with personalised help with healthy eating and lifestyle, and bespoke physical activity. So far, as I said at Health questions last week, more than 170,000 people have been referred to that programme. Those who are referred get tailored, personalised help, and that is really making an impact.

[Neil Gray]

It was remiss of me when talking about childhood obesity and lifestyle changes not to commend those who started and spread the daily mile challenge in our schools. Perhaps the Minister will touch on that, and on its roots in Scotland.

[Steve Brine]

I thank the hon. Gentleman for that point. I touched on child obesity, which is one of the top public health challenges, if not the top challenge, for this generation. Overweight and obesity-related ill health is estimated to cost the NHS in England about £5.1 billion each year. The estimated total cost to society is between £27 billion and £46 billion per year. Our child obesity plan, which was published back in 2016, is informed by the latest evidence and research in the area. At its heart is a desire to change the nature of the food that children eat and make it easier for families to make healthier choices. Since we published the plan, real progress has been made on sugar production. Since the introduction of the soft drinks industry levy, which I mentioned, sugar has been drastically reduced in around half of all soft drinks products that fall under the levy. I recognise the daily mile, which was rightly raised by the hon. Gentleman, which he said started in Scotland. It is in England as well, though not as much as I would like to see it—we have an ambition for it to do much better.

Many Members mentioned child obesity, and we have always been clear that the child obesity strategy is the start of a conversation and not the final word—we call it chapter 1 for a reason. We continue to monitor the progress we have made since the publication of the strategy a couple of years ago, and if further measures are needed we will take them.

Let me touch on physical activity, which the hon. Member for Blaenau Gwent rightly spoke about. People know that being active is good for their health and they want to do more, but the truth is that many of us are simply not active enough to benefit our health. Only 66% of men and 58% of women in England meet the chief medical officer’s recommendation to be active for at least 150 minutes a week. Children are no better, with only 23% of boys and 20% of girls being active for at least 60 minutes a day. As we get older, we become less active. It is recommended that we do muscle strengthening and balance exercises on at least two days a week, but the most recent health survey shows that only 1% of the adult population in England meet that guideline.

Why is that important? We are facing an ageing population and there is good evidence that being active reduces the chance of falls, depression and dementia by up to 30%. That will help people stay healthy and independent for longer, and we need that to happen if the NHS is to be sustainable for its next 70 years. People need to understand why being active is important and have a clear understanding of how much activity they should do and the impact that can have on their health. I was pleased to hear parkruns mentioned by a number of Members, including the hon. Member for Blaenau Gwent, because they are incredibly important. I have them in my constituency at the River Park leisure centre.

It is vital that we acknowledge the importance of good mental health, which was mentioned a couple of times in the debate. Everybody’s mental health is on a point on the spectrum and, as my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant) said, mental health is just the other side of the coin of physical health. Good mental health is so important to leading positive and productive lives and to the NHS. This is Mental Health Awareness Week, but really every day should be a mental health awareness day. Mental health is a key priority for the Secretary of State and the Prime Minister, which is why last December we published the Green Paper on children and young people’s mental health, backed by more than £300 million of funding to improve access to services and, crucially, mental health support in schools.

Just yesterday I was at the Maudsley Hospital in London, looking at the incredible work it has done in bringing us to a smoke-free NHS. We identified mental health in-patients as a key target in the tobacco control plan. I saw the important work being done, which I would recommend to any Members who think they could inspire their local areas to follow that lead.

My hon. Friend the Member for Ayr, Carrick and Cumnock was dead right to mention delayed transfers of care—delayed discharges—which are a key component and in many ways the magic key to the NHS. It is also always nice to hear Robert Burns quoted in the Chamber, but I am sorry that he did not sing it—maybe next time.

I understand why the hon. Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney) made the speech he did. He certainly put down a marker for the Scottish Government, who govern his constituents.

I thank my hon. Friend the Member for Henley for mentioning the long-term economic plan—I have not said that for a while—and the multi-year funding plan that the Prime Minister talked about at the Liaison Committee. He is dead right. That is exactly what we should be doing, and it is exactly what we will do.

As always, the hon. Member for York Central (Rachael Maskell) spoke from the heart about health matters. She mentioned the integrated public health plan for her city, which sounds great. Local application of what is good for local areas is right, and I look forward to hearing more about her local area when we meet.

The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) raised questions about the devolution settlement. Of course, we talk across England and the devolved nations, but the settled will of this Parliament and of the people in this country is that we have a devolution settlement. Devolution can bring difference, and that can be good or bad. Yes, we do talk and share best practice, and I know that NHS England and Public Health England talk to their counterparts in the devolved nations all the time.

On good and bad difference—this is not political knockabout; it is just some facts—it would be remiss of me, as a Conservative Health Minister, not to put on the record that since 2010 we have increased NHS spending each and every year, even as we have had to take some very difficult financial decisions, given the state of the public finances we inherited. The NHS now has £14 billion more to spend on caring for people than it did in 2010. To give that some context, over the past five years funding for the NHS increased in Wales by 7.2%, in Scotland by 11.5%, and in England by 17.3%. I say that not to make a political point; it is a simple fact that should be put on the record.

Let me take this opportunity once again to congratulate the hon. Member for Blaenau Gwent on introducing this timely and important debate. As we have seen, the challenges that the NHS faces are radically different from those it faced in 1948. The debate has shown us why we, the Government, the NHS and the people we all represent, wherever they live in this United Kingdom, are all part of the solution to the deep and significant public health challenges we face as a nation. They are also all part of the inheritance of that health service that we are all so proud of.

In the short time available I have tried to show how seriously the Government and the NHS take those challenges. We must use all the opportunities we have at our disposal and that long-term health economic plan—I like saying that—to address the big public health challenges facing our nation. Only through the combined efforts of the Government, the NHS and the people in our country who are taking responsibility for their own healthcare, as technology increasingly allows them to do, which was another good point made in the debate, can we truly tackle the public health challenges we face and make sure that the NHS does not just survive for another 70 years—we are not interested in that—but thrives and goes from strength to strength, being a preventive health service as much as a treatment health service. That will truly honour Nye Bevan and everyone else involved in its establishment back in the ’40s.

Oral Answers to Questions

Neil Gray Excerpts

Tuesday 8th May 2018 Commons Chamber

[Mr Hunt]

Most parts of the country would say that they need more GPs, which is why we are trying to improve the capacity across the country. So, what have we done? Well, very recently we announced six new medical schools, which will have a specific focus on attracting new students into general practice. That is one of a number of measures.

[Neil Gray (Airdrie and Shotts) (SNP)]

12. What recent discussions he has had with Public Health England on the potential merits of introducing minimum unit pricing for alcohol in England.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

The Government remain committed to tackling all alcohol-related harms, which is why we are developing a new alcohol strategy. As part of that, I am commissioning Public Health England to undertake a review of the evidence for minimum unit pricing in England.

[Neil Gray]

That is welcome news. The Scottish National party Government have taken the lead in this matter by taking the bold step to set a minimum unit price for alcohol as part of wider interventions to help tackle excessive consumption. In particular, they want to end the days of strong white ciders being sold at pocket money prices. The British Medical Association has long called for that, so at what stage will we learn of further progress in the Government’s thinking?

[Steve Brine]

The previous consultation in 2013 found that the evidence, as it stood at the time, was not entirely conclusive. That is still the case, which is why the Government intend to keep the policy under review. Many times in this Chamber we are given the benefit of experience north of the border as to whether a policy has been a success, but it is not always strictly spot on. Given that the policy only came in last week, it is probably premature to say that it is a success, but we will welcome the opportunity to see the evidence emerge from Scotland’s implementation of minimum unit pricing, and we will be watching very closely.

Psychosis: Early Intervention

Neil Gray Excerpts

Thursday 15th March 2018 Westminster Hall

[Neil Gray (Airdrie and Shotts) (SNP)]

Thank you for calling me, Mrs Moon. I should perhaps have said earlier that I would take only a short amount of time in my winding-up speech, particularly as we are discussing a devolved issue. I hope that the hon. Member for Faversham and Mid Kent (Helen Whately) did not have to cut what was a very good speech short. I should perhaps have indicated to you, Mrs Moon, that I only intended to take a short amount of time, to enable everyone to get the full coverage.

It is a pleasure to speak with you in the chair, Mrs Moon, on this very important subject. I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing the debate and pay tribute to his awareness-raising and campaigning work on this important issue over a great number of years, as has been mentioned. I also commend him for his detailed and comprehensive speech and, as I have indicated, for bringing people together today in search of consensual debate, especially when we consider that the topic is health, which normally divides political opinion. On this occasion it has rather united political opinion, so I commend him for that.

The right hon. Gentleman’s powerful speech was supported by others. The hon. Member for Stockton South (Dr Williams) spoke of the stark reality that sadly faces people who do not get access to early intervention following diagnosis with psychosis. He spoke with experience and knowledge of this issue, and added greatly to the debate. The hon. Member for Liverpool, Wavertree (Luciana Berger) has also worked tirelessly for a number of years on this issue. The statistic she cited—that just 3% of those with psychosis in her area are in employment—is quite frankly staggering. She also spoke of the prevalence of mental health vulnerability for women after childbirth. For me, those two issues alone, among all the others, highlight the importance of getting this right across all areas and why we all need to do more in all areas of this country, and all Governments should do that.

[Luciana Berger]

Forgive me, but in my remarks I was due to pass on a contribution by the hon. Member for Belfast East (Gavin Robinson), who wanted it made known on the parliamentary record that there is no mother and baby unit in Northern Ireland. Although the issue is not devolved, he wanted that point about the availability of support for new mums to be made in the context of this debate.

[Neil Gray]

I thank the hon. Lady for that intervention; it is clearly important that that is put on the record.

Also, as I have already indicated, the hon. Member for Faversham and Mid Kent made a very honest speech. Her observations from her clinical experience highlighted how destructive psychosis is, so I pay tribute to her for her contribution. I hope that the Minister will respond not only to hers, but to all the points raised by right hon. and hon. Members.

This issue is important, because when the Prime Minister entered Downing Street on 13 July 2016, she listed a number of “burning injustices” that she hoped to address, in order to make Britain

“a country that works for everyone”,

among which was the injustice that

“If you suffer from mental health problems, there’s not enough help to hand.”

Clearly, such rhetoric is to be welcomed, as is the Prime Minister’s promise that parity of esteem would be introduced in dealing with mental health services in the NHS in England. However, as demonstrated in I think all the speeches today, we have not really got to the point of matching that rhetoric with actions and outcomes. I think there was a universal acknowledgement in today’s speeches that not enough is being done.

Today’s debate focuses specifically on psychosis and the waiting-time standards for early intervention in this area. As we are all too aware, mental health in general often comes with many stigmas and misconceptions attached, and that is nowhere more apparent than in relation to the subject of today’s debate. In psychosis, people experience symptoms of paranoia, and often delusional belief systems that take them outwith reality—that was covered so well by the hon. Member for Stockton South. It affects sufferers socially and in terms of their work, education and overall health. Although only a small proportion of the population are impacted by psychosis, particularly compared with other mental health issues, its impact on the individual and those around them can be devastating, and sufferers require long-term support and help to recover.

As my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), who is herself a clinical psychologist, pointed out in a similar Westminster Hall debate in September 2016, behavioural family therapy is also extremely important. Psychosis affects not just the person who suffers, but their whole family and social circle. People can suddenly find themselves in a caring role, and research indicates that spending 10 hours or more a week as a carer can be a challenge to someone’s wellbeing.

As the subject of today’s debate and the contributions of many Members have made clear, early intervention is key to ensuring that the support and recovery process can be as successful as possible, for both the individual and those around them. In Scotland, the Scottish National party Government have made mental health one of their main priorities, and they will continue to place a high importance on mental health services. A key part of that prioritisation in relation to psychosis has been focusing on prevention and early intervention, particularly for infants, children and young people—it has already been said why that is important—who are the groups most likely to be impacted by the first episodes of psychosis.

Analysis undertaken by the King’s Fund recommended that

“Providing high-quality care to patients requires two things: first, that NHS trusts have the revenue to recruit and retain the correct mix of staff, and second that these staff exist and want to work for the NHS. Our analysis highlights that there are underlying issues with the supply and availability of key staffing groups in mental health. Investing in the skills, job satisfaction and wellbeing of our current workforce should be a priority, but we must also invest to ensure sufficient workforce capacity.”

In Scotland, the Government have attempted to address those important staffing and funding issues by increasing NHS mental health spending from £651 million in 2006-07 to £937 million in 2016-17, which has enabled the aim of placing an additional 800 mental health workers in key settings by 2022 to remain on course.

However, I am not trying to argue that there is no room for improvement in Scotland—clearly there is—and that everything is as good as it can be. Clearly, there is more that we could and should do. The Scottish Government are aware that there is room for improvement and their “Mental Health Strategy 2017-2027” has identified a number of areas where further improvements can be made. In particular, the strategy acknowledges that

“Working to improve mental health care is not just the preserve of the NHS or the health portfolio.”

Instead, improving mental health care requires improving a wide range of public services, such as education and justice, as well as addressing other important societal problems, such as poverty and employment, all of which have a relationship with mental health and a role to play in improving health outcomes.

Again, I commend the right hon. Member for North Norfolk, and I hope that the Minister, when she replies, will reflect on all the comments from the right hon. Gentleman and from others, and respond to the examples given from the frontline and to the asks that he and others from different parties have made today.