Oral Answers to Questions

Neil O'Brien Excerpts

Tuesday 11th July 2023 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

6. What assessment he has made of the potential impact of guidance issued by District Valuer Services on the availability of city-centre GP premises.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

While it is a very long-standing system, we keep the approach to funding for GP premises under review. We have taken action in the primary care recovery plan to improve access to section 106 funds, so that new homes always come with the GP infrastructure that is needed.

[Daisy Cooper]

The Secretary of State and his Ministers will know that I first raised this issue in the Chamber on 6 June this year. Integrated care boards, GPs, and now the medical property sector are all telling me that the Treasury rules are out of date and are a massive block to securing much-needed primary care premises in the right places, particularly in city centres such as St Albans. When I have asked the Department via written parliamentary questions for its assessment of how much of a problem this issue is, the Department has told me that it just does not know. Could the Minister please tell us when he will be speaking to colleagues in the Treasury to resolve this issue, so that we can make sure that GP premises are secured where people need them most?

[Neil O'Brien]

We talk all the time. I am conscious that there are 60% more full-time patient-facing staff in the hon. Lady’s constituency than there were in 2019, which of course puts pressure on premises. The capital allocation for her local ICB between 2022-23 and 2024-25 was £200 million, so the money is there, but I am happy to continue the conversation about how we get the premises in the places where we need them.

[Chris Green (Bolton West) (Con)]

7. What recent progress he has made on increasing the range of services in pharmacies.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

We have already been growing the range of NHS services available in pharmacies: we have set up the community pharmacist consultation service, the discharge medicines service, the new medicine service, the blood pressure check service, smoking-cessation services and the contraception service. We are now investing £645 million to go further through the new Pharmacy First scheme for common conditions.

[Chris Green]

I thank my hon. Friend for his answer, but does he agree that the services offered by pharmacies can be made more efficient? For example, 62 million prescription items are subject to “split and snip” per year. That is where, to get the right number of pills, a pack has to be manually opened up for a couple of pills to be snipped out, then repackaged and relabelled before being reissued. The spare pills are often thrown away. Can that system not be better?

[Neil O'Brien]

My hon. Friend is completely correct. That is why at the end of last month we laid a statutory instrument before the House to fix the system, so that pharmacists can spend more time using their skills to provide high-end clinical services and less time snipping blister packs.

[John Cryer (Leyton and Wanstead) (Lab)]

Given the national shortage of GPs, does the Minister recognise that there is a potential danger in asking pharmacists to take on the duties of GPs—duties that they are not necessarily qualified to undertake—especially given the already large workload undertaken by pharmacists?

[Neil O'Brien]

We absolutely recognise the need for patient safety, which is why there will be clear patient group directions and clear pathways about what pharmacists do. They are not taking on the role of GPs, but are providing additional services that will make things more convenient for all of our constituents.

[Dame Maria Miller (Basingstoke) (Con)]

I warmly welcome the Government’s commitment to investing £645 million to enable pharmacists to provide for far more common conditions. I have already visited one of my own local surgeries, the Shakespeare Road medical practice, and seen at first hand how pharmacists are already working in GP surgeries to try to reduce waiting times. Surely, more surgeries should be doing the same, involving pharmacists with enhanced roles in order to cut waiting times in a manner that is safe.

[Neil O'Brien]

My right hon. Friend is completely correct. That £645 million, of course, comes on top of the £100 million that we have already put in. We have grown the pharmacy workforce hugely—there are 82% more pharmacists now than in 2010—and we are also enabling those people with their high-end skills to do more by reforming regulations. That is not just the blister packs issue; we are enabling them to do convenient things such as hand out bagged medicines even if the pharmacist is not present.

[Mr Gregory Campbell (East Londonderry) (DUP)]

Will the Minister undertake to liaise closely with local community pharmacy representative groups to ensure that the excellent work they have been doing can be maximised, particularly given that the NHS is under severe pressure at the moment?

[Neil O’Brien]

Absolutely, and I always try to learn lessons from right across the UK. In fact, some of the ideas for reforms have come from listening to local partners. For example, our reforms to enable modern ways of working, hub-and-spoke dispensing and empowering pharmacy technicians have come from talking to those local partners.

[Mr Speaker]

I call the shadow Minister.

[Karin Smyth (Bristol South) (Lab)]

People across the country rely on local, accessible pharmacies, but whether it is high street closures or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and other drugs, the Government are again letting people down. They have repeatedly announced plans to expand the role of community pharmacies, but have failed to update legislation that could possibly help. They keep collapsing the business in this place, so we have time to sort it. Why will they not do so?

[Neil O’Brien]

I have given a flavour of the four different reforms we are making. To give the wider picture, there are more pharmacies in England than there were in 2010, there are 24,000 more pharmacists in England than there were in 2010 and we are putting in £645 million to provide a bunch of services that were not there when Labour was in office. We are very happy to take lessons from the pharmacy sector, but not from the Labour party.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

8. What steps he is taking to help improve the effectiveness of brain cancer treatments.

--- Later in debate ---

[Kate Osborne (Jarrow) (Lab)]

10. What steps he is taking to help tackle health inequalities.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

We are tackling the root causes of health inequalities. We have doubled the duty on cigarettes and brought in a minimum excise tax on the cheapest cigarettes. That has helped to drive down smoking rates from 21% to a record low of 13%. We are going further, helping a million smokers with our scheme to get people to stop smoking and start vaping. We have provided £40 million to start rolling out new weight-loss drugs and, in the major conditions strategy, we will talk further about how we will tackle health inequalities.

[Kate Osborne]

People in the north-east die younger than people in the rest of England and spend more years in ill health. Increased NHS waiting times leaves them on medication for longer. The north-east has the highest level of people living in poverty, leaving many of my constituents unable to afford prescription charges. Some have told me that they are taking paracetamol instead of prescribed medication, worsening health inequalities. Will the Minister commit to scrapping these unfair prescription charges?

[Neil O’Brien]

Nine out of 10 prescriptions are not paid for, but free at the point of delivery. On the various important points that the hon. Lady makes, tackling health inequalities is hugely important to us. That is why we are creating 160 extra community diagnostic centres, which are targeted at areas of the highest deprivation. It is why we are rolling out targeted lung health checks in 43 areas of the most deprivation. It is also why we are providing cost of living support worth about £3,300 for the average household in this country. It is one of the most generous schemes anywhere in Europe, exactly to tackle those cost of living pressures and health inequalities.

[Mr Louie French (Old Bexley and Sidcup) (Con)]

My hon. Friend will be aware that health inequalities can also be geographical within the south-east, with boroughs such as Bexley having historically received less funding than other parts of London. Does he therefore agree that further investment in the fantastic Queen Mary’s Hospital Sidcup would address that issue and improve health outcomes for people in south-east London?

[Neil O’Brien]

My hon. Friend is assiduous in making the case for his constituency. Ministers of course will meet him to discuss this matter. I know he is closely following the progress of the CDC bid, which we have been talking about. Those diagnostic centres are doing fantastic work to get earlier diagnosis and save more lives, particularly in areas of deprivation.

[Mr Speaker]

I call the shadow Minister.

[Andrew Gwynne (Denton and Reddish) (Lab)]

From this complacent Minister’s replies already, one would think that health inequalities in England were improving, not widening. Last year, 11,000 people, including 312 children, were hospitalised for malnutrition in the United Kingdom. That is the highest number since comparable records began. Why are so many people in Britain going hungry under the Tories?

[Neil O’Brien]

We need to have care in discussing these subjects. Eating disorders are a sensitive subject and the statistics the hon. Gentleman is quoting are a mix of different things. I have already talked about the £3,300 of cost of living support that this Government are providing to the average UK household, with more targeted help for more vulnerable households. It is something we are seized of and are working on.

[Mr Speaker]

I call the SNP spokesperson.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

Millions of people with disabilities or serious medical conditions rely on specialist equipment, such as ventilators or home dialysis, which personally costs them more money to run, while giving considerable savings to NHS hospitals. Will the Minister urge Cabinet colleagues in the Department for Work and Pensions to help to tackle health inequalities by ensuring that those people receive a fair and timely reimbursement for those additional costs, which are essential to run the equipment to help keep them alive?

[Neil O’Brien]

Absolutely. We are conscious of the additional needs of people who have equipment like that. By the end of June, the Government had covered nearly half of a typical household’s energy bill through the support schemes we put in place, but we are always looking at what more we can do to help vulnerable households.

[Ian Byrne (Liverpool, West Derby) (Lab)]

11. What assessment his Department has made of the potential impact of primary care service closures on public health.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

Each integrated care board is required to ensure access to GP services for all. Overall, more people are being seen in general practice than ever before—about 10% more than before the pandemic—but where some practices close, the local ICB has to ensure that patients are transferred smoothly to other practices.

[Ian Byrne]

Park View medical centre in West Derby, one of the most deprived areas of my city, is facing imminent closure, and there has been a lack of transparency and accountability throughout the process when dealing with the ICB to get the decision reversed. In the Minister’s reply to my letter, he said it was essential that, if a GP surgery closes, it does not lead to a reduction in the quality of care for patients in the locality. Park View patients have been clear that dispersal to other surgeries would be catastrophic, especially when all GPs are already facing huge pressures. Will the Minister urgently intervene to halt the closure due to the legal insufficiency of the consultation process and meet me and patients?

[Neil O’Brien]

I have looked carefully at that case, on which the hon. Gentleman has been campaigning. The incumbent provider chose not to bid for the future contract for Park View medical centre, and NHS Cheshire and Merseyside decided that the best thing was to help patients to transfer to neighbouring practices. Patients will only be transferred to practices rated as good, and there are 10 other practices rated as good within a 1-mile radius of Park View. Since 2019, there has been an increase in the number of patient-facing staff of about 50% in the constituency. That means there are more people in his GP surgeries. We are working hard to ensure high-quality GP services in his constituency.

[Virginia Crosbie (Ynys Môn) (Con)]

Health is devolved to Labour in Cardiff. Ynys Môn is represented by five Members of the Senedd, yet health represents a third of my postbag, particularly relating to access to primary care in Holyhead. Does the Minister agree that families in Holyhead are not getting the healthcare they need and deserve?

[Neil O’Brien]

Yes, it is true, I am afraid. People are about twice as likely to be waiting for treatment in the Welsh NHS. Waits are also longer in Wales, with 30,000 people waiting more than two years for treatment, even though those have been eliminated in England. England spends more on general practice than Scotland or Wales, despite the fact that Wales has 20% more funding, and England has also grown spending on general practice faster than either Scotland or Wales. We are highly focused on getting good primary care services in England. There are always lessons that we can learn from each other, but there are definitely lessons that Welsh Labour can learn from the English NHS.

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)]

12. What steps his Department is taking to create a vaccine development and evaluation centre.

--- Later in debate ---

[David Johnston (Wantage) (Con)]

T2.   I have campaigned for more health services for my constituents since I was elected, and 97% of those who responded to my recent health services survey felt that we did not have enough doctors for the number of people in the constituency. Will my hon. Friend meet me to discuss how to sort this out and get my constituents the health services that they deserve?

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

We are conscious that more is going on in general practice than ever before. There are 10% more appointments than before the pandemic, as well as 29,000 extra clinicians and nearly 2,000 more doctors, but we are conscious of the pressures that puts on the estate locally. I would be very happy to meet and have further conversations with my hon. Friend.

[Kirsten Oswald (East Renfrewshire) (SNP)]

T3. I am sure that the Secretary of State shares my concern that school nurses report increasing rates of children presenting with health issues resulting from poor nutrition. In Scotland, the SNP Government have rolled out universal free school meals for all pupils in primary years 1 to 5 and special schools, and the expansion of the programme continues. What discussion has the Secretary of State had with Cabinet colleagues about following Scotland’s lead and expanding free school meal provision in England to improve children’s health and wellbeing?

--- Later in debate ---

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

A recent report by the Trussell Trust warns that people facing hunger are more likely to be affected by spiralling debt and a decline in their physical and mental health. The same report shows that one in seven people in the UK faced hunger in the last year due to a lack of money. Will the Minister make representations to his colleagues at the Department for Work and Pensions about increasing support for low-income households, thereby improving public health outcomes for all?

[Neil O’Brien]

It is to protect public health that we have provided cost of living support worth £3,300 on average per household, and that is why we have been paying about half of people’s average electricity and other energy bills. However, we always look at further things we can do to drive improvements in public health.

[Andrew Lewer (Northampton South) (Con)]

T7. What steps is the Department taking to prevent chronic kidney disease, given that the recent report published by Kidney Research UK predicts a significant rise in cases of kidney failure in 10 years’ time?

--- Later in debate ---

[Jason McCartney (Colne Valley) (Con)]

T8. Many of my constituents are still struggling to get NHS dental appointments, so what is happening right now—this week, this month—to increase the availability of NHS dental appointments for them?

[Neil O’Brien]

I know how intensely my hon. Friend is campaigning on this issue. The amount of NHS dentistry being delivered has gone up by a fifth over the last year, partly as a result of the reforms we are already rolling out. He will have seen in the workforce plan that we are going to increase training places for dentists by 40% so that we have the NHS dentists we need. However, that is not all we will do, and our forthcoming dental plan will take further steps.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

We have known for a while that our life expectancy is shorter than it was in 2010. However, we are now seeing impacts on children in the UK, who are about 7 cm shorter at five compared, for example, with the children of our neighbours in Holland. What is the Secretary of State doing on this issue, and will he support the all-party parliamentary group on health in all policies in assessing the impacts on health and health inequalities?

[Neil O’Brien]

Of course we are taking action to improve public health, and that includes children’s nutrition. That is why we are spending £150 million on healthy food schemes, such as the school fruit and vegetable scheme, the nursery milk scheme and Healthy Start. It is also why we are investing £330 million a year in school sport and the PE premium and a further £300 million through the youth investment fund. We will continue to take action on this key issue.

[Mr Jonathan Lord (Woking) (Con)]

I am delighted that a new diagnostic centre is shortly to be built at our terrific Woking Community Hospital, very close to Woking town centre. Does the Minister agree that providing state-of-the-art diagnostic care right in the heart of the community can cut NHS waiting lists, reduce carbon emissions and, most importantly, help to optimise health outcomes for patients?

Electronic Cigarettes

Neil O'Brien Excerpts

Thursday 29th June 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

It is a pleasure to serve under your chairmanship, Mrs Latham.

I start by thanking my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who is a former colleague in the Department for Health and Social Care. I thank her not only for this debate and her brilliant speech, which was full of interesting observations and ideas, striking and concerning anecdotes, and great wit, but for her work in really driving the debate on vaping in recent months and years. She has been a leading voice in this area. Likewise, I thank my right hon. Friend the Member for Calder Valley (Craig Whittaker) for his interesting insights.

Before I get into the main body of my speech, I will address some of the specific issues raised. My hon. Friend the Member for Sleaford and North Hykeham asked about the availability of prescription products. The reason they are not available is that the producers have not come forward with them at this stage. We remain hopeful that that will happen, but we are reliant on commercial companies wanting to do it. That is not about concerns that it is less safe than smoking; it is just about commercial partners bringing that forward for approval.

The SNP spokesperson, the hon. Member for Paisley and Renfrewshire North (Gavin Newlands), pointed out that, interestingly, vaping products are not available in China, even though it exports them to the rest of the world. I do not think that that has as much to do with the Chinese Communist party’s position on public health as it does with the fact that it gets huge revenues from its ownership of the tobacco industry, which is still extremely big in China. I think it has more to do with that than with an enlightened view on the relative safety of vaping and smoking.

The Opposition spokesman, the hon. Member for Ilford North (Wes Streeting), asked specifically what we are doing on smoking. Smoking rates came down from some 40% in the 1970s to 21% in 2010, and they are now at a record low of 13%. That is partly because we have doubled excise duties and brought in a minimum excise tax on the cheapest cigarettes, but it is also because we continue to take further measures, including the measures I announced recently, such as the help for a million smokers to “swap to stop”, which is an innovative, world-first policy, and our provision of health incentives to help those smoking during pregnancy to stop. We know from partners in local areas that evidence-based policy works. Much has been done and there is yet more to do in the future.

I absolutely understand the concerns, and I am just as motivated as my hon. Friend the Member for Sleaford and North Hykeham by the challenge of youth vaping. Until recently, our regulations, such as the minimum age of sale, advertising restrictions and the cap on nicotine levels, had been holding down vaping rates. However, over the last two years we have started to see a surge in the use and promotion of cheap, colourful products that do not always comply with our regulations. As hon. Members have mentioned, there has been a sharp increase in children vaping and the awareness of vaping. That is of great concern to me, for exactly the same reason that it concerns my hon. Friend.

Despite its high effectiveness as a tool to help adults quit smoking, we are absolutely aware of the risks that vapes pose to children. Vapes are not risk-free. Nicotine is highly addictive, it can be harmful and there are unanswered questions on long-term use, as raised by my hon. Friend. As Professor Chris Whitty, the chief medical officer, said:

“If you smoke, vaping is much safer; if you don’t smoke, don’t vape”.

Last month, the Prime Minister announced several new measures to tackle youth vaping, including taking steps to close the loophole in our laws that allows the vaping industry to give out free samples of vapes to under-18s. Recent data suggests that 2% of 11 to 15-year-old ever vapers—approximately 20,000 of them—said that they were given it by a vape company, so we will stop that.

Secondly, the Prime Minister announced that we will update the health education curriculum to teach kids about the risks of vaping, as called for by my hon. Friend, just as schools do for the risks of smoking and excessive drinking. To support that, the Office for Health Improvement and Disparities is producing a new resource pack for schools on vaping for the start of the new academic year. The resources have been informed by research with teachers and young people. The activities will feature films made with young people in which they will talk in their own words about the issues around vaping, as well as a clear presentation of the latest evidence. Those resources build on other content we have already produced for young people, including on the Frank and Better Health websites, and input into educational resources produced by partners including the Personal, Social, Health and Economic Education Association.

The Prime Minister also announced that we will review the rules on selling nicotine-free vapes to under-18s, to ensure that our rules keep pace with what is happening in the industry, and review the rules on issuing fines to shops selling vapes to under-18s, to allow local trading standards to issue on-the-spot fines and fixed penalty notices more easily. That will complement existing fine and penalty procedures and cover both illegal and underage sales for vapes and tobacco. Those steps build on measures we are already undertaking.

Earlier this year, in April, I announced new measures to step up our efforts to stop kids getting hooked on vaping. First, we launched a call for evidence on youth vaping to identify opportunities to reduce the number of children accessing and using vape products, and to explore where Government can go further. That explored a range of issues, several of which were touched on by my hon. Friend, including the appearance and characteristics of vapes, the marketing and promotion of vapes, and the role of social media, as touched on by the hon. Member for Paisley and Renfrewshire North. It sought to better understand the vape market, looking at issues such as the price of low-cost products, mentioned by my hon. Friend, and the environmental impact of vapes. The call for evidence closed on 6 June, and Department of Health and Social Care officials have begun to carefully examine the responses. We will be publishing our response in early autumn, identifying and outlining areas where we can go further.

I also announced in April that we are going further to enforce the existing rules on vaping. I announced a specialised illicit vaping enforcement squad, which is a dedicated team to tackle underage vape sales and the illicit products that young people have access to. That will hold companies to account and enforce our current rules. We are providing an extra £3 million to trading standards, which will help share knowledge and intelligence across the country. It will undertake test purchasing, disrupt illicit supply, including from organised crime gangs, and remove illegal products from shelves at our borders, which will tackle the horrifying issue raised by my hon. Friend about the content of some illicit vapes. There will be more testing to ensure compliance with our rules, and we will be bolstering the training capacity of trading standards too.

Companies failing to comply with the law will absolutely be held to account. In some cases, we have already got companies to withdraw products from their shelves if they have not met our rules. I am pleased to announce that National Trading Standards has begun setting up the operation, gathering intelligence, training staff and bolstering capacity to begin field work later this summer.

I absolutely appreciate the calls for single-use vapes to be banned due to their environmental impact, and also because of their appeal to young people. In 2022, about 52% of young people who vaped used disposable products, compared with just 8% in 2021. We are concerned by the increasing use of these products and their improper disposal, for the reasons my hon. Friend mentioned. We are exploring a whole range of options to address this through the youth vaping call for evidence.

This is absolutely not a reason for not doing anything, but one of the issues we will have to deal with is the nature of the industry, which is based in Shenzhen, is highly nimble and manufactures lots of different things. It will be a challenge to address issues specific to disposable vapes, because the industry will try to get around them by saying, “This is potentially refillable.” In theory, my biro is refillable, but in practice, and if it was cheap, it can simply be thrown away. Careful consideration needs to be given to the question of what is and is not disposable, if we are going to put some weight on it. I am not in any way arguing that nothing can be done, but extremely careful thought is required to ensure that the actions we take are highly effective.

All vapes, including single-use vapes, fall within the scope of the UK’s Waste Electrical and Electronic Equipment Regulations 2013, which require importers and manufacturers of vapes to finance the cost of collection and proper treatment of all equipment that is disposed of via local authority household waste sites and returned to retailers and internet sellers. From an environmental perspective, the starting point must be to assist businesses to understand their obligations and bring them into compliance. If we can achieve that, the environmental impacts can be reduced. The Department for Environment, Food and Rural Affairs will shortly be consulting on reforming the WEEE Regulations to ensure that more of this material is properly recycled.

We are committed to doing all we can to prevent children from starting vaping, and we are already taking robust action in a range of areas. We are also looking closely at how we can go further. As I mentioned, early this autumn we will publish the response to the youth vaping call for evidence and outline our next steps, and we want to move fast.

[Craig Whittaker]

Before the Minister concludes, does he have any thoughts on the World Health Organisation forum in Panama this November and whether the UK will be subscribing to the WHO requests or pursuing our own policies as a sovereign nation?

[Neil O’Brien]

My right hon. Friend asks an important question. We will set out our position for that conference of the parties in due course. On the question of heat-not-vape products, they are, as far as one can see from the evidence, more dangerous and contain more toxic chemicals than vapes, so there is a concern about the use of those products. When I was on the Science and Technology Committee, I remember looking at all these different products and the new things on the market. There is a substantial gap in terms of safety. It may be that they are safer than smoking, but there are serious concerns about the health effects of heat-not-burn products—even more significant than those about vapes, which have been raised in this debate.

I end as I began by paying tribute to my hon. Friend the Member for Sleaford and North Hykeham for all the work she has done to drive this important debate. As constituency MPs, we all see this important and growing issue in our schools and through talking to young people. We are moving at pace and will continue to do so to address these challenges. It is important that we calibrate our approach correctly so that it is effective. We have already done a number of things, and we stand ready to do more to tackle this extremely important issue.

Ultra-processed Food

Neil O'Brien Excerpts

Wednesday 21st June 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

It is a pleasure to serve under your chairmanship, Dr Huq. I am particularly grateful to my hon. Friend the Member for Stourbridge (Suzanne Webb) for securing this debate, which is timely and deals with an incredibly important issue, which I am very interested in. I recently met Dr Van Tulleken and the Scientific Advisory Committee on Nutrition, and we are working on this at pace, so I welcome the debate.

One of the great challenges with ultra-processed food is defining what it is. The most commonly used definition, as we have heard, is the NOVA definition, which includes foods that are clearly less healthy, such as sugary drinks, confectionery, salty snacks, cakes and other products that are high in calories, saturated fat, salt and sugar. A diet high in those things increases the risk of excess weight gain and obesity. We are committed to tackling obesity, and have a programme of measures to do that. We have introduced calorie labelling in cafés and restaurants, and since last October we have introduced location restrictions on less healthy foods to reduce pester power. An advertising watershed will be introduced in 2025. That requires numerous steps, and we are taking them.

For children and young people, we are spending £150 million a year on healthy food schemes, such as school fruit and veg and nursery milk, through our Healthy Start scheme. We are also putting in £330 million a year for school sport and the PE premium. In addition, there is a £300-million youth investment fund in facilities to encourage an active lifestyle, and we are spending about £20 million a year on the national child measurement programme, which aims to nip problems in the bud. Only a few weeks ago, the Prime Minister made an announcement on funding a £40-million start in the use of new weight loss drugs for those living with obesity.

[Maggie Throup]

Are the Government still committed to halving child obesity by 2030?

[Neil O'Brien]

Yes. We are working with food businesses and we have set out direct measures to further progress reformulation, which is crucial to helping people to make healthy choices. The soft drinks industry levy decreased the amount of sugar in soft drinks by 46% between 2015 and 2020, and the voluntary sugar reduction programme has delivered a nearly 15% reduction in average sugar levels in breakfast cereals and a 13.5% reduction in yoghurts and fromage frais. Together, these policies are expected to accrue health benefits of about £60 billion, producing savings for the NHS.

Although a significant amount of work has been published, there is no universally agreed definition of ultra-processed food; nor is there an evidenced position. We do have definitions of products that are high in fat, salt and sugar, and that is the basis on which we regulate and control those foods. The Scientific Advisory Committee on Nutrition provides the Government with robust, independent advice on the science and the underpinning evidence base. SACN is clear that there is evidence that a diet high in calories, fat, salt and sugar is bad for people’s health. The question then is what ultra-processing adds to that impact. Is it something about the ease of eating these foods, or what it does to someone’s physiology? Are the products in some way addictive, or is it something else entirely?

Some people say, “Why don’t you just adopt the NOVA definition?” but the breadth of the NOVA definition is such that it includes foods that our current dietary guidelines encourage as part of a healthier diet. Shop-bought wholemeal bread, baked beans, or wholegrain breakfast cereals such as bran flakes and Weetabix would be captured by it, so clearly there is work to do to reach the right definition. Some of the foods that I have mentioned can make a positive contribution to nutrient intakes: for example, fortified breakfast cereals or bread and pasta made from fortified wheat flours are the largest source of dietary iron in all age and sex groups and provide, on average, between a third to a half of our calcium intake.

Defining the problem is not completely straightforward. To make progress so that we can start to regulate or do anything else, we need to have a clear definition. However, even though how to define these things is not totally obvious, that does not mean that there is not a problem, that we will not take action, or that we cannot find a solution. We all know it when we see it—I particularly admired the definition of my hon. Friend the Member for Erewash (Maggie Throup) that having an unpronounce-able ingredient is a pretty good sign—but we need to be precise and follow the scientific evidence.

That is why SACN is carrying out the scoping review of the evidence on processed foods and health, which includes reviewing existing processed food classifications and the ability to apply NOVA to UK diets and our national diet and nutrition survey. SACN aims to publish its initial assessment this summer, so we are moving quickly. We are also in touch with other countries in the same position, and I know that France and Canada are doing similar work. As part of the review, SACN will consider whether there is sufficient evidence to undertake a full risk assessment. Only after an in-depth risk assessment and the identification of robust supporting evidence would we consider updates to Government dietary advice.

The Eatwell Guide, which most Members present will know about, summarises dietary recommendations and shows how much of what we eat overall should come from different food groups to achieve a healthy, balanced diet. It recommends that we consume less often, and in smaller amounts, food and drinks that are high in saturated fat, salt or free sugars. Foods such as crisps, biscuits, cakes, ice cream and sugary drinks are all shown outside the main Eatwell Guide image to highlight that they are not necessary. Those foods also meet the NOVA definition of ultra-processed foods.

The Eatwell Guide and associated messaging is promoted through a range of channels, including the NHS and gov.uk websites, and the Government’s national social marketing campaigns, such as Better Health. We know from our national diet and nutrition survey that most people in the UK are not meeting the dietary recommendations depicted in the Eatwell Guide. Aligning diets more closely with existing dietary recommendations will deliver considerable population health benefits and healthcare savings.

Obviously, one of the things that we are doing to achieve those benefits is supporting people with the cost of living so that they can afford to do it. Support for the cost of living, which we have provided through both energy price support and direct measures for poorer households, has been worth £3,300 for the average household over last year and this year—one of the most generous support packages anywhere in Europe. We are absolutely conscious of the challenges around the cost of food at the moment, caused by the Russian invasion of Ukraine.

Even as we focus on the cost of living, we are still very much focused on obesity, because it accounts for a significant cost to the NHS and the economy. That is what we are doing with our existing programme on obesity and healthy eating. We know that there is more to do, and we will do more. Our major conditions strategy has a call for evidence that runs until 27 June, seeking people’s views on how the healthcare system can support people to lead healthier lives, including supporting them to achieve and maintain a healthy weight. We know that diet has an important impact on health. My hon. Friend the Member for Stourbridge has raised important concerns about ultra-processed foods, which we are looking at.

Our existing policies support less consumption of many of the foods that would be classified as ultra-processed because they are high in fat, salt and sugar. We know that they are a problem, and that is why we regulate in the way we do. It is vital that we take a considered and robust approach to the emerging evidence on what ultra-processing is doing. That is what we are doing, and we will not hesitate to take action if the evidence suggests that it is needed.

Volume Price Promotion Restrictions

Neil O'Brien Excerpts

Tuesday 20th June 2023 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

The Government are announcing their intent to delay the implementation of restrictions on volume price promotions, such as “buy one get one free” or “3 for 2” offers, on less healthy products by 24 months. These restrictions will now come into force on 1 October 2025.

Given the current challenges caused by higher food prices, the Government do not want to take actions that may restrict consumer choice.

Therefore, we are delaying the restrictions until October 2025 in light of the unprecedented global economic situation.

The intention of the promotion restrictions is to shift the balance of promotions towards healthier options, encouraging people to make healthier choices. We will continue to work closely with food businesses to reformulate products to be healthier. We have already seen success in some categories of the sugar reduction programme including a 14.9% reduction in average sugar levels in retailer and manufacturer branded breakfast cereals and a 13.5% reduction in yogurts and fromage frais.

The delay to volume price promotions does not impact the location restrictions which are currently in force. Under these restrictions, less healthy products in scope can no longer be promoted in key locations, such as checkouts, store entrances, aisle ends and their online equivalents. The location restrictions are the single most impactful obesity policy at reducing children’s calorie consumption and are expected to accrue health benefits of over £57 billion and provide NHS savings of over £4 billion, over the next 25 years.

We intend to consult in the coming weeks on the secondary legislation to implement the delay to the volume price restrictions.

The Government remain committed to halving childhood obesity by 2030 and delivering on these measures.

[HCWS868]

Smokefree 2030 Target

Neil O'Brien Excerpts

Tuesday 20th June 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

It is a pleasure to serve under your chairmanship, Mr Sharma. I thank my hon. Friend the Member for Harrow East (Bob Blackman) and the hon. Member for City of Durham (Mary Kelly Foy) for securing this hugely important debate, and I thank other hon. Members for some excellent speeches. I was haunted by the image, conjured up by the hon. Member for Birmingham, Erdington (Mrs Hamilton), of people with COPD being wheeled outside to have one more gasp—I think we have all seen things like that. It has also been a pleasure to have contributions from all four parts of the UK. I shall try to respond to as many of the questions as possible.

In 2019, the Government produced a Green Paper on preventive health, in which we introduced our ambition for England to become smoke free by 2030. The ambition aims to shift the focus from treating ill health to preventing it in the first place. That means three things: first, discouraging children and adults from starting; secondly, helping smokers to quit; and thirdly, moving smokers to less harmful alternatives, such as vapes.

That is exactly what we have been doing over the last decade, and we have made significant progress. In recent years, the Government have introduced a range of legislation. We have introduced a UK-wide system of track and trace for cigarettes and hand-rolling tobacco to deter illicit sales, and from May 2024 that will cover all tobacco products, including shisha and cigars. We have continued to invest in stop smoking services, to help smokers get the right support for them. We continue to support the NHS, and last year alone provided £35 million to the NHS long-term plan commitments on smoking. Of course, we have also doubled duty on cigarettes and introduced a minimum excise tax on the cheapest cigarettes. Between them, those measures have helped to ensure that adult smoking prevalence in England is at its lowest level on record, 13%, and that youth smoking rates are the lowest on record—in 2021, 3.3% of 15-year-olds were regular smokers.

If we are to achieve our 5% ambition by 2030, however, we must move faster and be bolder. That is why on 11 April I introduced a package of new measures to help make more progress. To help smokers quit and move towards less harmful alternatives, we announced funding for a new national “swap to stop” scheme, which is the first of its kind in the world at a national level, to encourage 1 million smokers to swap cigarettes for vapes. We have begun to set up pathfinders, where local authorities can apply for starter kits, and the first shipments of vapes should begin going out later this summer. Local authorities across the country have expressed an interest, and we are also working with social landlords, homelessness charities, jobcentres, food banks and all the other groups that can help smokers to quit.

Despite its effectiveness as a tool to quit smoking, we must be aware of the risks that vaping poses to children and non-smokers, as various Members have pointed out. Over the past couple of years, we have seen an alarming rise in children vaping, and that is why we are taking action. We recently held a call for evidence to look at all the opportunities to reduce the number of children using vape products. It closed on 6 June and we are analysing the responses. We will publish our response within 12 weeks.

To stop children buying vapes, we need to get businesses to comply with our regulations and abide by the standards we have set. Of course, there are retailers out there selling vapes to children. That is why we recently created a new enforcement unit, which has three priorities: to tackle products imported and traded illicitly, to remove illegal products from the market that do not comply with our regulations, and to stop under-age sales to children. The unit will help remove illegal products from shelves, stop them coming through our borders and stop the sale of vapes to children.

[Dr Hudson]

I thank the Minister for articulating some of the risks around disposable vapes. I want to raise the risks they pose to animals. Just the other day, I was out walking my young dog Poppy and she came out of the undergrowth with a bright pink, melon-flavoured disposable vape in her mouth. I was able to get it out of her mouth, but, as a vet, I shudder to think what would have happened if she had chewed, crunched or swallowed it. Does my hon. Friend agree that we need more public awareness of the risks of vapes to health, the environment and even animals?

[Neil O’Brien]

That is a fascinating point, and my hon. Friend is absolutely right that we need to be aware of the environmental and wider impacts of disposable vapes as we consider our next steps.

At the end of May, the Prime Minister announced several further measures to address youth vaping, including closing the loophole that allowed industry to give out free samples, increasing education and supporting dedicated school police liaison officers to keep illegal vapes out of schools. The measures support our wider approach to tackling youth vaping—not only preventing supply, but reducing demand. We also need to take action against businesses that break the rules and protect businesses that abide by them.

As well as non-compliant vapes, the illicit trade in tobacco undermines our work to protect public health. To answer the question from the hon. Member for Arfon (Hywel Williams), His Majesty’s Revenue and Customs will produce a new strategy to tackle illicit tobacco later this year. The strategy will outline joint efforts to catch and punish those involved in the illegal market and will build on the work we are already doing—my hon. Friend the Member for Harrow East alluded to it—to use the registration system as a way to improve enforcement.

Another big priority is to help pregnant women quit smoking. The rate of smoking in pregnancy remains stubbornly high; increasing the number of women who have a smoke-free pregnancy is crucial. To help expectant mothers, we have set up a financial incentive scheme, married with behavioural support. We aim to ensure that every pregnant mother who smokes across England gets help to quit. That work is based on a successful scheme in Greater Manchester, which has seen one of the biggest drops in smoking in pregnancy anywhere in the country.

To help more smokers quit, we need to be more innovative in how we connect with them, with the right type of support and messaging at the right time. To address the question asked by the hon. Member for Blaydon (Liz Twist), we are going further on mental health and are ensuring that everyone who is in mental health treatment is signposted to stop smoking services, because there is a link between the two.

Another potential opportunity that hon. Members have raised is our plan to provide pack inserts in smoked tobacco packets, with positive messages and information to help more smokers quit. We intend to launch a UK-wide consultation shortly and are engaging with devolved Administrations on the matter. To answer the question raised by the hon. Member for Strangford (Jim Shannon), we are absolutely having those conversations.

We are committed to doing all we can to prevent people from starting smoking, to give smokers the support they need to quit, and to tackle the damage from the illicit market. I talked about some of the measures that I recently announced, but we will have more to say in the major conditions strategy in the not-too-distant future. I thank my hon. Friend the Member for Harrow East and the hon. Member for City of Durham for securing this hugely important debate, and I look forward to making further progress towards our ambition for a smoke-free England and a smoke-free UK by 2030.

Sight Testing in Special Schools

Neil O'Brien Excerpts

Monday 19th June 2023 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

I am pleased to announce that NHS England will make available sight testing to all special schools from 2024-25.

We know that children with a learning disability are 28 times more likely to have a serious sight problem, and over 40% require glasses. Whilst free NHS sight tests are available for all children, the Government acknowledge the particular challenges faced by children and young people who attend special school settings in accessing high street sight testing services and also the benefit of these settings in receiving personalised advice on optimising the environment for learning.

The NHS Long Term Plan made a commitment to provide sight testing in special residential schools. To meet that commitment, NHS England commenced a proof-of-concept programme in 2021 to pilot a potential sight testing service model. This pilot was subject to an independent evaluation. As a result of that evaluation, NHSE is proposing to build upon the Long Term Plan commitment and extend provision to all children in special education day schools.

NHS England now intends to undertake a period of engagement with key stakeholders, schools, and the public over summer 2023, in order to share the learning from the proof-of-concept scheme and further develop the care model that will underpin the proposed future of the new expanded sight testing scheme. Following which NHS England will publish a revised service specification and roll-out plans.

Whilst this engagement is undertaken existing contractors will continue to operate under the current proof-of-concept arrangements until such time as NHS England complete its engagement and confirms the future commissioning arrangements.

I hope this will be welcome news and I thank those from across the eye care sector who have helped to shape this valuable service.

[HCWS861]

Prescription Charge Upper Age Exemption: Consultation Outcome

Neil O'Brien Excerpts

Thursday 15th June 2023 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

In 2021, the Department of Health and Social Care held a public consultation on aligning the upper age for the NHS prescription charge exemption with the state pension age (SPA), which is currently 66, and due to increase to 67 and 68 in future years. The upper age for NHS prescription exemption was introduced in 1968 to be in line with the women's state pension age, which was 60 at that time. In the decades since, there have been increases to the state pension age, but the upper age exemption for prescription charges has remained the same.

The consultation received over 117,000 responses, the majority of which were opposed to the proposed change. Responses cited, among other issues, cost of living pressures and risk to health of people not taking prescribed medication correctly as reasons for retaining the current upper age exemption. The Government are committed to tackling cost of living pressures and has decided that the prescription charge upper age exemption will remain at 60, meaning that it will not change to align to state pension age.

It should be noted that, in England, a broad range of NHS prescription charge exemptions are in place to help those with greatest need. These measures include a variety of charge exemptions, and eligibility depends upon whether people are in receipt of certain qualifying benefits or tax credits, their age, receipt of a war pension or have a qualifying medical condition. The current exemptions mean that around 89% of NHS prescription items dispensed in the community in England are free of charge, in addition, those on a low income who do not qualify for an automatic exemption can seek help under the NHS low income scheme. For those who do not qualify for an exemption or the NHS low income scheme, prepayment certificates (PPC) are available to help those who need frequent prescriptions. The annual PPC can be paid for through 10 instalments, and covers all prescriptions in that period for just over £2 per week.

[HCWS851]

Stem Cell Transplant Patients

Neil O'Brien Excerpts

Monday 12th June 2023 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

I congratulate the right hon. Member for Alyn and Deeside (Mark Tami) on securing this important debate, and I congratulate the other hon. Members on speaking interestingly about their personal experiences in this field. As chair of the all-party parliamentary group on stem cell transplantation and advanced cellular therapies, the right hon. Member for Alyn and Deeside speaks from particular personal experience and I think everyone will have been delighted to hear the wonderful update about Max.

For people living with blood cancers and blood disorders, stem cell transplants are a potentially life-saving treatment. That is why we continue to invest in improving clinical outcomes and access to transplants. Since 2011, Government funding of more than £28 million has made possible the establishment of a unified stem cell registry, a cord stem cell bank, and a strategy to recruit donors to meet the needs of our increasingly diverse population. Over the next three years, we are investing £2.4 million more to increase the resilience of the UK stem cell supply and to address health inequalities with targeted campaigns to recruit donors from ethnic minorities. The right hon. Gentleman mentioned Anthony Nolan, which gives me the opportunity to thank that charity for its tremendous work with the NHS to build up the stem cell register.

As we know, the very nature of these transplants means that patients are among the most vulnerable in society. They are left with seriously weakened immune systems, for all the reasons the right hon. Gentleman has given. To help households and individuals to cope with the rising costs of living, we are providing some of the most generous cost of living support in Europe, worth an average of £3,300 per household this year and last. As well as the action on energy prices, that includes payments to more than 8 million UK households receiving eligible means-tested benefits, and to 6 million people across the UK in receipt of eligible “extra-costs” disability benefits.

For those needing extra support, the Government are providing an additional £1 billion to allow the extension of the household support fund in England this financial year. Our energy price guarantee is helping millions of people to deal with rising energy costs, and, as the Chancellor announced in the spring Budget, it will be extended, at £2,500, for an additional three months from April until the end of June. That means that by the end of June we will have covered nearly half a typical household’s energy bill, with a typical household saving about £1,500.

The right hon. Gentleman rightly raised the importance to patients of keeping warm, and the warm home discount is a key policy in our programme to tackle fuel poverty and help low-income households with the cost of energy, whatever the reason for their low incomes. It gives low-income and vulnerable households throughout Great Britain an annual £150 energy bill rebate every winter, and since it began in 2011 we have provided more than £3.5 billion in direct assistance for households. The scheme obliges participating suppliers to provide rebates for eligible low-income and vulnerable households.

In order to target fuel poverty better and provide the vast majority of rebates automatically, we have expanded and reformed that scheme for England and Wales from 2022-23 onwards. That includes those receiving universal credit, for which stem cell transplant patients may well be eligible. Depending on their specific needs, stem cell transplant patients may be entitled to financial support to contribute towards their extra costs, which may include the personal independence payment. PIP can be paid in addition to the other financial and practical support that may be available through universal credit.

The Government are committed to ensuring that people can access this financial support in a timely manner. While waits are still too long, they are coming down dramatically and we are constantly improving the service. Claimants are kept informed and are updated at each stage of the process—for instance, through a text message service—and in most instances any awards can be backdated to the date of the claim.

I know—not least because of the right hon. Gentleman’s comments this evening—that rising travel costs represent a significant burden for stem cell transplant patients and their families. Recipients of certain benefits, including the personal independence payment, can apply for extra help with travel costs, such as a disabled person’s railcard, a blue badge or a vehicle tax reduction. NHS trusts can also exercise discretion to provide accommodation and other support, including transport, depending on local and individual patient circumstances. Depending on their financial circumstances, patients may be able to access extra help with travel costs, such as the NHS low-income scheme and healthcare travel costs scheme.

[Mark Tami]

Does the Minister accept that if we require patients to attend specialist centres—which I fully support; indeed, perhaps we need to go further in that regard within the NHS—we should think about how we can help those who have to travel long distances to cover their costs, given that they cannot receive that treatment at the hospital down the road?

[Neil O’Brien]

I would agree with the hon. Gentleman. I was talking about one scheme, the healthcare travel costs scheme, but patients might also be eligible for non-emergency patient transport, on which we spend about £500 million a year across England. We will continue to look closely at the future of that, not least because of the hon. Gentleman’s comments this evening.

[Jim Shannon]

Patients in my constituency who come to me feel almost compelled to go back to work because they do not have the finances, but they cannot do so because they are not fit enough. Could the Minister’s Department ensure that those people who find themselves in difficult financial circumstances have someone to speak to who could perhaps direct them through the process so that they can get help?

[Neil O’Brien]

The hon. Member makes a good point, and I am happy to continue this conversation with him after the debate. He always provides thoughtful ideas and I am keen to continue talking about that one with him.

For those people who are going through all this at the moment, I have mentioned some of the schemes that are available for transport, such as the healthcare travel costs scheme and non-emergency patient transport, but we will continue to look at those to make sure that they are adequate to get patients to the specialist treatment they need.

In closing, let me again thank the right hon. Member for Alyn and Deeside for securing today’s really important debate and for his thoughtful contribution. Stem cell patients and their families and carers show tremendous courage in the face of incredible challenge, and we will continue to do whatever we can to support this vulnerable community.

Question put and agreed to.

HIV Action Plan: Annual Update 2022-23

Neil O'Brien Excerpts

Thursday 8th June 2023 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

I am pleased to update the House on the publication of the first annual update to Parliament on the HIV action plan. In January 2019, the Government committed to an ambition to end new HIV transmissions, AIDS diagnoses, and HIV-related deaths within England by 2030. Achievement of these ambitious commitments—including our interim commitment to an 80% reduction in transmissions by 2025—is within our grasp, and we should be encouraged by the progress already made. This progress is testament to the collective and ongoing efforts of many organisations across the UK Health Security Agency, local government, the NHS and wider health system, statutory agencies, and the voluntary and community sector.

As part of the plan, we committed to update Parliament each year on the progress made towards our ambition to end new HIV transmissions, AIDS, and HIV-related deaths within England by 2030. I am proud to present to Parliament a summary of the work undertaken towards these objectives in 2022-23.

Despite the challenging backdrop of the covid pandemic, England has seen a 33% fall in new HIV diagnoses since 2019. NHS England has committed £20 million in funding for 2022 to 2025 to expand HIV opt-out testing in emergency departments in areas with the highest HIV prevalence. This has helped diagnose 2,000 new cases of blood-borne viruses (hepatitis B and C as well as HIV) in the first year of the programme. During National HIV Testing Week 2023 almost 22,000 free HIV testing kits were ordered by the public—with self-testing kits that provide instant at-home results available for the first time. We have also established the HIV Action Plan Implementation Steering Group to oversee progress, as well as a Community Advisory Group and four task and finish groups to support PrEP access and equity; workforce; HIV control strategies in low prevalence areas; and retention and engagement in care, and I look forward to seeing the impact they will make.

[HCWS838]

Mental Health Treatment and Support

Neil O'Brien Excerpts

Wednesday 7th June 2023 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

I beg to move an amendment, to leave out from “House” to the end of the Question and add:

“notes the increased burden on mental health following the pandemic, including on young people and those with severe mental illness; recognises the historic levels of investment being delivered by this Government into services, with an increase of £2.3 billion per year in front-line mental health funding over the past four years; notes that current NHS targets around access to talking therapies and intervention in psychosis are being met due to the efforts of NHS staff; and acknowledges the investment in mental health teams in schools, as well as the ongoing investment into open access mental health helplines in the 111 service and into the estate, including three new mental health hospitals to be opened in the next two years accompanied by a further £150 million in investment in new mental health ambulances and the development of better alternatives to accident and emergency services, including crisis houses, safe havens and step-down services.”

Improving mental health is a top priority for this Government. We can all agree that in the past it was not given the priority it deserves, and was seen as something to be ashamed of and not spoken about. Thankfully, we are changing that. We are working to achieve parity of esteem between physical health and mental health, with record amounts of investment going into NHS mental health services in England, and the stigma surrounding mental health is being reduced.

“The Five Year Forward View for Mental Health”, which was published in 2016, was a major step forward and secured an additional £1 billion in funding for mental health, so that an additional 1 million people could access high-quality services by 2020-21. It was followed by the NHS long-term plan in 2019, which committed an additional £2.3 billion a year for the expansion and transformation of mental health services in England by 2024, so that an additional 2 million people could get the NHS-funded mental health support that they need. It is also funding the increase in the frontline mental health workforce to meet the plan’s ambition for 27,000 additional mental health staff by 2023-24. There were 138,610 full-time equivalent mental health staff at the end of 2022, an increase of 8,900 on the previous year and of 20,700 on December 2010, so the mental health workforce in the NHS is radically bigger. In total, we spent around £3 billion more on mental health last year compared with four years ago. That is an increase of a quarter.

Backed by this huge investment, we are expanding access to NHS talking therapies for adults to meet the long-term plan’s ambition for an additional 1.9 million people to access National Institute for Health and Care Excellence-approved treatments for conditions such as anxiety and depression. From starting small in 2008, around 1.2 million people are now accessing NHS talking therapies every year, with 98% waiting less than 18 weeks for their treatment and 90% waiting less than six weeks. This means that we are delivering well over our national waiting time targets of 95% and 75% respectively.

Local mental health services are transforming community mental health care to give 370,000 adults and older adults with severe mental illnesses greater choice and control over their care and to support them to live well in their communities. We recognise that poor mental health is a major cause of sickness absence in the workplace and we are providing support to employees and employers on mental health in the workplace. We have announced additional measures to support workplace mental health, including a package to support the long-term sick and disabled to remain in or return to work. This includes £200 million for digital mental health to modernise NHS talking therapies, to provide free access to wellness and clinical mental health apps for the population, and to pilot cutting-edge digital therapeutics. There will be around £75 million to expand individual placement and support services to help more people with severe mental health illnesses into employment.

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

Will the Minister give way?

[Neil O’Brien]

I will make a little progress first.

We know that the number of children and young people experiencing mental ill health is rising, and that many of them will continue to experience mental health problems later in life. Spending on children and young people’s mental health continues to grow, from £841 million in 2019-20 to £995 million a year later, and now to £1.1 billion in 2022-23. This means that we are helping more children and young people than ever before. In 2021-22, there were over 743,000 new referrals to children’s and young people’s mental health services, which is 41% higher than the year before.

[Several hon. Members rose—]

[Neil O’Brien]

I will make a bit of progress before I give way.

The long-term plan will ensure that 345,000 more children and young people can get the mental health support they need when they need it.

We are committed to ensuring that children and young people can access mental health support in school, so that they can access help with anxiety and depression and other common mental health services before problems become more serious. In that way, we can prevent—in exactly the way we all agree on—the problems from becoming more serious. That includes continuing to roll out mental health support teams to schools and colleges in England.

[Fleur Anderson (Putney) (Lab)]

The picture that the Minister is painting does not quite tally with the experience that I am seeing in families, many of whom are watching with a feeling of helplessness as their children’s mental health deteriorates while they are on long waiting lists. In the NHS South West London ICB area, there are over 10,000 young people on waiting lists, and many have their cases closed without even getting the support they need. That leaves them with deteriorating mental health and it leaves their families in despair. How is it that the money the Minister is talking about does not seem to get through to the young people who need help?

[Neil O’Brien]

I will come to the point about waiting lists in a moment.

Let me complete my thoughts on prevention, which I think we all agree is important. There are 3.4 million pupils covered by mental health support teams in 2022-23, which equates to about 35% coverage of pupils in schools and learners in further education in England. We expect around 500 teams to be up and running by 2024, covering around 44% of pupils and learners, so it will be up from 35% to 44%. Over 10,000 schools and colleges now have a trained senior mental health lead, including more than six in 10 state-funded secondary schools in England. On prevention, the Government are also providing £150 million of capital investment in NHS mental health urgent and emergency care infrastructure over the next two years.

[Andy McDonald (Middlesbrough) (Lab)]

While the Minister is addressing the issue of young people, can I say that I have yet to hear any news from the Department as to whether there will be a public inquiry into the deaths of the three young women who died under the care of the Tees, Esk and Wear Valleys Foundation NHS Trust. Can he enlighten me on that?

[Neil O’Brien]

This is an extremely important issue that the hon. Gentleman is quite right to raise. We will be producing the results of the rapid review in the coming weeks, so he will not have to wait very long.

[Munira Wilson]

Like other colleagues, I see many children in my constituency waiting well over a year, sometimes two years, to access child and adolescent mental health services, so I was alarmed when NHS England recently told me that, on the latest modelling, the number of NHS-commissioned training posts in London for child and adolescent psychiatry will halve by 2031. I have no idea what is driving this modelling, but given that one in six seven to 16-year-olds have a probable mental health disorder, will the Minister at least look into these figures and undertake to write to me to explain why we are seeing such a drop in the number of training places?

--- Later in debate ---

[Neil O’Brien]

Those are not figures that I am familiar with or recognise, but I will certainly take this up with the London commissioners because it sounds like an important issue. I have talked about the dramatic increase we have already seen in the mental health workforce, and we are setting out further steps in our long-term workforce plan, but I will take that away and look at it closely with other Ministers.

[Mr Toby Perkins]

One of the issues here is that the demand for mental health services has gone through the roof, from 3.6 million in 2020-21 to 4.5 million in 2021-22. My hon. Friend the Member for Tooting (Dr Allin-Khan) was clear in her view, which I share, that the policies of this Government have been a factor in driving up the mental health demand. Does the Minister accept that? If not, what does he put it down to?

[Neil O’Brien]

I was just coming to that, but on the point about prevention and the social origins of these things, we are in agreement about tackling the origins of these things. In terms of financial security, that is why we are providing financial help worth £3,300 per household, one of the most dramatically generous packages anywhere in Europe. The question of good housing was raised earlier. We have the Social Housing (Regulation) Bill and we are taking action to extend the decent homes standard to the private rented sector.

[Dr Luke Evans (Bosworth) (Con)]

Is it not the case that we have to be really careful about what we are talking about? There is a difference between mental wellbeing and mental health. We all suffer with our mental wellbeing but we do not all suffer with our mental health, and we therefore need to have the support that is appropriate. Social prescribing, for example, has a fundamental ability to help people who suffer with their mental wellbeing. Are the Government doing anything more to drive up social prescribing, so that GPs and allied professions can get the support from the third sector and other voluntary organisations that people so desperately need for their mental wellbeing?

[Neil O’Brien]

My hon. Friend, as an experienced clinician, makes an important and thoughtful point. This is exactly why we have so dramatically increased the number of social prescribers in primary care. An example in Britain is the parkrun practices initiative, which is connecting people to sporting and cultural activities that can improve mental wellbeing as well as mental health. My hon. Friend is completely right, and that is why this is a priority for us.

[Andrew Bridgen]

The suicide rate in North West Leicestershire increased by more than 300% during the lockdown. Does the Minister know what the increase was in his constituency?

[Neil O’Brien]

It is just not true there was an increase in suicides because of the lockdowns. There have been a whole series of careful studies of this and that is just not the case. I am afraid that my hon. Friend is not correct about this.

[Wera Hobhouse (Bath) (LD)]

Eating disorders are a national scandal and have reached epidemic proportions. Anorexia nervosa has the highest mortality rate of any mental health disorder and a third of people with binge eating disorders are at suicide risk. With at least 125 million people suffering from eating disorders and with soaring waiting lists, is it not time that the Government appointed something like an eating disorder prevention champion to tackle this incredibly difficult but rising crisis?

[Neil O’Brien]

I completely agree about its tremendous importance, and I take this opportunity to mention the incredible work on this hugely important issue by brilliant charities such as Beat. I will outline some of the general things we are doing to increase capacity further.

[Janet Daby]

Only a few weeks ago, I met a constituent who endured an awful kidnapping and rape. She had some initial counselling and therapy from specialist services, but she has now been on the waiting list for more than a year and a half. What would the Minister say to my constituent, who desperately needs therapy?

[Neil O’Brien]

I am terribly sorry to hear about the hon. Lady’s constituent’s case, which I will look at extremely closely. This is why we are putting in extra investment and tackling waiting lists.

[Several hon. Members rose—]

[Neil O’Brien]

I should make a little progress before taking further interventions.

The Government are providing £150 million of capital investment in the NHS’s urgent and emergency care infrastructure for mental health over the next two years. Those interventions include £7 million for 90 new mental health ambulances, with the remaining £143 million going to more than 160 capital projects with a preventive focus. These include new urgent assessment and care centres, crisis cafés and crisis houses, health-based places of safety for people detained by the police and improvements to the NHS 111 and urgent mental health helplines. The hon. Member for Tooting talked about creating such facilities in the community, and we are already doing that. We are also investing £400 million between 2020-21 and 2023-24 to eradicate mental health dormitory accommodation, improving safety and dignity for patients. Twenty-nine projects have already been completed since the programme commenced in 2020-21, eradicating over 500 dormitory beds.

[Dr Ben Spencer]

Will the Minister join me in welcoming the construction of the new Abraham Cowley unit, which will eradicate the dormitories that were in my constituency?

[Neil O’Brien]

I join my hon. Friend in celebrating that unit and his advocacy for people affected by mental health.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

I thank the Minister for giving way, as I appreciate that he is trying to make progress. On the capital programme, one of the issues that my hon. Friend the Member for Tooting (Dr Allin-Khan) highlighted is Seni’s law, which will look at the treatment that patients receive in mental health units, where, sadly, restraint has led to deaths. The Minister talks about prevention, and we need to make sure that Seni’s law, which was enacted in November 2018, comes forward now. Does he agree?

--- Later in debate ---

[Neil O’Brien]

The remaining provisions will be commenced as soon as possible.

We are working with the NHS towards implementing new waiting time standards for people requiring urgent and emergency mental healthcare, in both A&E and the community, to ensure timely access to the most appropriate high-quality support. We also recognise that there is much more to be done to improve people’s experience in in-patient mental health facilities. The Minister with responsibility for mental health, my hon. Friend the Member for Lewes (Maria Caulfield), has spoken to many Members following reports of abuse and care failings at a number of NHS and independent providers. We have been clear that anyone receiving treatment in an in-patient mental health facility deserves to receive safe, high-quality care and to be looked after with dignity and respect.

It is vital that, where care falls short, we learn from any mistakes to improve care across the NHS and to protect patients. That is why we have conducted a rapid review of mental health in-patient settings, with a specific focus on how we use data and evidence, including from complaints, feedback and whistleblowing reports, to identify risks to safety.

[Marsha De Cordova (Battersea) (Lab)]

The Minister wants to talk about data and evidence. We know that, within the mental health crisis, there are huge, long-established racial disparities, with young black men disproportionately being sectioned under the Mental Health Act 1983. The draft mental health Bill is still in train, and I would like to know exactly when the Government will table the Bill, which might stop these racial disparities and stop young black men dispro-portionately being sectioned.

[Neil O’Brien]

We are currently responding to pre-legislative scrutiny, so we are on the case. We are not just waiting, of course, and we are already doing things on these points, including through the culturally appropriate advocacy pilots for those at risk of detention and on the patient and carer race equality framework to avoid and prevent detention in the first place.

The rapid review’s report will be published very shortly. NHS England has also established a three-year quality transformation programme that seeks to tackle the root causes of unsafe, poor-quality in-patient care, including sexual safety, in mental health, learning disability and autism settings.

Our draft mental health Bill, which has been mentioned a few times in this debate, is intended to modernise the Mental Health Act so that it is fit for the 21st century and works better for people with serious mental illness. The draft Bill has completed its pre-legislative scrutiny, and we will respond to the Joint Committee’s recommendations very shortly.

In a world of increasing rates of multiple morbidity and diseases of increasing complexity, it is crucial that we continue our progress towards more person-centred, holistic care that considers a patient’s physical and mental health needs together. That is why we announced in January that we will be producing a major conditions strategy to tackle the conditions that contribute most to morbidity and mortality across the population of England, including mental health. The call for evidence is now open, and I encourage everyone to make their views known before it closes.

[Liz Twist (Blaydon) (Lab)]

The Minister is talking about the mental health strategy now being part of the major conditions strategy. Is he aware that many mental health organisations see it as a retrograde step that, having conducted an extensive consultation and invited views, the strategy will now be put back even further?

[Neil O’Brien]

I assure the hon. Lady that all contributions were fed into the major conditions strategy process. The reason why we are making the mental health strategy part of the major conditions strategy, and why we are looking at co-morbidities, is because, as the hon. Member for Tooting mentioned, people with mental health conditions have a shorter lifespan and, in general, the cause is typically a physical co-morbidity. It is essential that we look at these things together if we are to make progress on tackling disparities.

We have committed to publishing a new national suicide prevention strategy later this year, and we are engaging widely across the sector to understand what further action we can take to reduce cases of suicide. The new strategy will reflect new evidence and the national priority for preventing suicide across England, including action to tackle known risk factors and targeted action for groups of concern. We are also providing an extra £10 million over the next two years for a suicide prevention voluntary, community and social enterprise grant fund. This competitive grant fund will help to support the sector to deliver activity that can help to sustain services to help meet increased demand for support and to embed preventive activity that can help to prevent suicide and stem the flow into crisis services.

[Liz Twist]

Of course it is good that we will have a refreshed national suicide prevention strategy, and of course £10 million is welcome, but it is not out there yet. In the meantime, the £57 million that was earmarked for local work on suicide prevention has run out. Will the Minister consider making urgent interim arrangements to ensure that this vital work can continue until the strategy is published?

[Neil O’Brien]

I am conscious that we need to help the sector to maintain and grow its levels of service.

I finish by paying tribute to all those who do so much to support people’s mental health: frontline NHS staff, those working in the voluntary community and social enterprises, and all those who are quietly supporting a family member or loved one.