Health and Social Care

Neil Parish Excerpts

Thursday 16th January 2020 Commons Chamber

[Anne Marie Morris (Newton Abbot) (Con)]

That was a very thought-provoking, emotional and personal contribution from the hon. Member for Vauxhall (Florence Eshalomi), who I very much welcome to this place. She made some very important points about the NHS and knife crime, and I look forward to her working with all of us in this House to deliver exactly what she rightly says we must. I congratulate her.

It is right that health and care are a substantial part of this Gracious Speech, but it must be about action, not just words and promises. Across the House, whichever party we represent, we must deliver on what our constituents need and want and what we have promised them. I welcome the inquiry into social care. My concern is that this has been promised by Governments for years, and it seems to be taking forever and a day. This is urgent—it cannot wait. We must talk cross-party and look at the work that has been done, rather than do it all over again. Let us look at what works and does not work, take the good and move forward. I would like to see a Bill on social care in this Parliament.

Integration is another key issue. Members across the House have pushed for integration, and we need to make it happen. NHS England has proposed legislation to unblock the things preventing this from working. I am pleased to see the Bill to implement the NHS long-term plan, but I would like it to be more ambitious. It is right to address the commissioning challenge, but the Bill does not address the overlapping regulatory system, the conflicting accountability between health and social care or any of the legal relationships. Where are we with sustainability and transformation partnerships and integrated care systems? They have no legal status, yet we look to them to deliver a solution on integration. More must be done, and we must be bold.

Across the Chamber, we agree that mental health is a priority, but again, where is the ambition? Dealing with detention is crucial, but we must also look at parity of esteem. It is not defined. We talk about mental health representing something like 23% of the burden on the NHS, but how is that measured? Is that really the totality of the issue? We need to define parity of esteem, be clear how we will measure the need and address that need as a matter of urgency. We talk about achieving parity of esteem over the next 10 years, but that seems an incredibly long time. I would like to see a proper plan, and I would like to see parity considerably sooner than 10 years from now.

There was an extremely well-made speech a little earlier about wellbeing. For so long, we have talked about the NHS and health, but actually we talk about illness, not about wellness. When we talk about Public Health England, that is not the only part of trying to ensure wellbeing. Professor Dame Sally Davies, the former chief medical officer, has said that wellness is as important as dealing with illness. I would like to see that fully addressed, and I very much hope that those on the Front Bench are listening and will take that seriously.

The assets that we have to address our problems are not infinite. We have some wonderful people, we have some wonderful infrastructure—buildings and hospitals—and we have some wonderful technology.

[Neil Parish (Tiverton and Honiton) (Con)]

My hon. Friend is making a really strong speech. Talking of assets, in my constituency we have community hospitals in Honiton, Axminster and Seaton, which could be used to much greater effect to take some of the pressures off the acute hospitals. Honiton does good work with Ottery St Mary and others in the neighbouring seat of East Devon. Can we actually get these assets working better for us? I welcome what the Secretary of State said in his speech earlier.

[Anne Marie Morris]

My hon. Friend makes a very good point, and I was very pleased to hear the Secretary of State say that community hospitals were valuable. We must have a fundamental rethink of the infrastructure and look at what we really need. In rural areas, where we cannot get to the best stroke centre, say, we must think seriously about how we use or reuse such facilities.

Baby Loss Awareness Week

Neil Parish Excerpts

Tuesday 8th October 2019 Commons Chamber

[Caroline Dinenage]

The hon. Gentleman has put his thoughts clearly on the record, and if there is anything we can ever do to share best practice with colleagues across the devolved nations and around the rest of the world, we are always happy to do that.

The Healthcare Safety Investigation Branch is another remarkable innovation. It commenced investigations in April 2018 and has been operational in the 130 trusts providing maternity services since the end of March 2019. By the end of August, the HSIB had completed 88 investigations, with 169 draft reports looking into maternity and neonatal deaths currently with trusts and families.

NHS Resolution recently published a report on the first year of its early notification scheme for potential birth brain injuries. The scheme requires all births at NHS trusts in England from 1 April 2017 meeting qualifying criteria to be reported to NHS Resolution within 30 days for investigation, so families with a baby affected by a severe brain injury attributable to substandard care can receive significantly earlier answers to their questions. This approach means that they do not have to resort to full court proceedings and can receive financial support with their care and other needs at a much earlier stage. In the first year, 746 incidents were eligible for the scheme. There have been early admissions of liability for 24 families, who have been provided with detailed explanations, admissions of liability and, very importantly, an apology. Families have been provided with financial support for early access to additional care, respite and, where needed, psychological support and counselling.

I am happy to report that this summer the Office for National Statistics reported that the stillbirth rate in England had decreased from 5.1 stillbirths per 1,000 births in 2010 to four stillbirths per 1,000 births in 2018. That represents a 21% reduction in stillbirths two years ahead of our ambitious plan.

[Neil Parish (Tiverton and Honiton) (Con)]

I thank the Minister for Baby Loss Awareness Week and for her statement. Let me reiterate that many mothers want to have a natural childbirth, and it is essential that they can do so if possible, but we also need to make sure that the facilities are there in all of our maternity units to be able to act if a natural birth does not take place, so that we can deliver the baby without any brain injury.

[Caroline Dinenage]

My hon. Friend is right, and so much of what the Government have been working on in recent years is about making sure we have the right facilities, skills and knowledge right across our NHS estate.

Let me reiterate what I mentioned a moment ago, which is that we have seen a 21% reduction in stillbirths two years ahead of our ambitious plans. Of course every stillbirth is a tragedy, but I am sure the House will want to join me in paying tribute to midwives, obstetricians and other members of multi-disciplinary maternity and neonatal teams across the NHS for embracing the maternity safety ambition that we set, and for their incredible hard work in achieving this milestone two years ahead of target—that is remarkable. However, there is no room for any complacency, because there is so much more to do.

Many Members will be aware that the neonatal mortality rate in 2017 was only 4.6% lower than it was in 2010, and that headline figure hides the fact that the ONS data show that the number of live births at very low gestational ages, most of whom die soon after birth, increased significantly between 2014 and 2017. In fact, the neonatal mortality rate in babies born at term—that is, after at least 37 weeks’ gestation—decreased by 19% and the stillbirth rate in term babies decreased by 31.6% between 2010 and 2018. The pre-term birth rate remains 8%. Clearly, the achievement of our ambition depends significantly on reducing those pre-term births.

Oral Answers to Questions

Neil Parish Excerpts

Tuesday 6th February 2018 Commons Chamber

[Stephen Barclay]

I admire how the VAT element of the original question was brought into a discussion of exit payments. As my hon. Friend will be well aware, I visited the issue of exit payments frequently as a member of the Public Accounts Committee, and I am happy to discuss it further with him.

[Neil Parish (Tiverton and Honiton) (Con)]

10. If he will increase funding for the Food Standards Agency’s national food crime unit.

[The Minister of State, Department of Health and Social Care (Caroline Dinenage)]

The Food Standards Agency’s national food crime unit is crucial to protecting consumers from serious criminal activity that impacts on the safety of their food and drink. I understand that the FSA is exploring options for the unit’s future funding, and a decision is expected in late spring.

[Neil Parish]

The FSA is answerable to the Department of Health and Social Care for food safety, but there are a lot of assurance schemes that do not really answer to anybody and which the FSA needs to be able to bring together. That is where the crime unit could do a really good job, so anything the Minister can do to get that money and get the crime unit up and running would be very good.

[Caroline Dinenage]

I thank the Chair of the Environment, Food and Rural Affairs Select Committee for his advice. I know that he is keen and astute on this subject. Ensuring that food businesses meet their safety responsibilities is, of course, one of the FSA’s most important roles. It is developing a new regulatory model and actively engaging with third-party assurance scheme owners to determine how information and data can be shared and more effectively used by regulators.

Ambulance Services (Devon)

Neil Parish Excerpts

Wednesday 12th July 2017 Westminster Hall

[Dr Sarah Wollaston (Totnes) (Con)]

I beg to move,

That this House has considered ambulance services in Devon.

It is a pleasure to serve under your chairmanship, Mr Davies. Let me say at the outset that we all pay tribute to our blue light services and that this debate is not in any way intended to criticise them. The intention is to set out the challenges that they confront and to celebrate their professionalism and the work that they do, but also to ask my hon. Friend the Minister to address some key issues that they face in Devon and, in particular, in my constituency.

The debate has been triggered by a number of incidents. People have contacted me either directly or indirectly to raise concerns about long waiting times faced by my constituents; an incident that typifies the situation happened last month. An elderly lady was left for two hours at the roadside, on a baking hot day, waiting for a paramedic crew to arrive. She had serious neck injuries and was in some distress. Were it not for the kindness of passing strangers, things might have been even worse, but a consultant anaesthetist happened to be passing and was able to provide critical assistance at the scene, and the lady also had assistance from the police and from staff from South Hams Community Hospital. As a result, the outcome has been good, but it could have been very different. That has caused a great deal of concern, because it is not an isolated incident. Although much of the focus of my speech will understandably be on the critical, type 1 cases, which require a response within eight minutes—everyone understands that—I would like the Minister also to think about those other cases that we are all coming across in our constituencies which are not immediately life threatening but are nevertheless very serious and where the outcome can be very different unless we see a timely response from our ambulance services.

First, I would like to address demand, which is rising at an extraordinary rate. During the five years to 2016-17, over the area of the South Western Ambulance Service NHS Foundation Trust we have seen a considerable rise in demand, but there has been a 19.2% increase in the Totnes constituency alone, a 29% increase in Plymouth and a 23.7% increase in Torbay. The challenge is far greater in a rural setting, for obvious reasons. The SWASFT area is the most rural area in England; and if we look at the activity for Devon, we see that 23.5% of SWASFT’s activity is in that county, but that is matched by only 22.2% of its funding.

[Neil Parish (Tiverton and Honiton) (Con)]

I very much appreciate the debate that my hon. Friend has introduced in the Chamber today. She is making a very good point about the rurality of Devon, which is one of the largest counties in the country. Of course, the issue is not just its size. If one starts going north-south, there are no really fast roads—we need much more done to the north Devon link road. Apart from the scale of the county, however, the issue is about getting an ambulance to an incident in time and our very scattered population. My hon. Friend makes a very good point. I am sure that Ministers are aware of the size of Devon, but there is also the question of the time it takes to get from A to B if one is not going on major roads.

[Dr Wollaston]

I thank my hon. Friend for his intervention. Of course, as we know, demand can escalate considerably during the peak summer times, but many of our roads are single-track ones with passing spaces, and it can be very difficult to get an ambulance resource to the scene in a timely manner.

My first point to the Minister is that there are no concessions for rurality; there is no funding premium to allow SWASFT to meet the extra demands that it faces. In fact, overall, its funding has fallen by 2.46% per incident in 2017-18, compared with 2014-15. It has to meet the huge increase in demand with shrinking resource, in what is one of the most challenged areas in England because of rurality. I would like the Minister to acknowledge that key point and the impact of rurality on response times.

My second point to the Minister is that although overall SWASFT is doing a good job in meeting the performance target of 75% of category 1 calls receiving a response within eight minutes, that does rather mask the picture in the most rural parts of the area. Let us take the South Devon and Torbay clinical commissioning group area as a whole, for which we have some data that show that it just meets the target, with the figure of 75.65% of calls. If we look at the breakdown for the Totnes constituency, we see that during the past three months the figure has been 61%, so my point to my hon. Friend is that, when considering a county such as Devon, he should look not just at the overall, top-line figure, but at the impact in the most rural parts of the constituencies. I hope that he will ask for that as an ongoing measure, as a response to this debate.

Healthcare (Devon)

Neil Parish Excerpts

Tuesday 18th October 2016 Westminster Hall

[Neil Parish (Tiverton and Honiton) (Con)]

It is great to serve under your chairmanship, Mrs Main. I thank my right hon. Friend the Member for East Devon (Sir Hugo Swire) for obtaining this debate, which is very timely.

Consultation should be about consultation. The CCG has presented four options: in option A Tiverton has 32 beds, Seaton 24 and Exmouth 16; in option B Tiverton has 32, Sidmouth 24 and Exmouth 16; in option C Tiverton has 32, Seaton 24 and Exeter 16; and in option D Tiverton has 32, Sidmouth 24 and Exeter 16. There is no sign of Okehampton or Honiton hospitals on the consultation. Beds there are simply said to be closed. Is that consultation? In our original reforms of the health service we said that local people must be consulted. Angela Pedder did exactly the same in Axminster, two years ago, as is being done now; she just came and said the beds were to be closed. There were no alternatives or consultation—just “We have made the decision, we know best, and we will overrule anybody who says any different.”

I tell the Minister that that is not consultation; we must make sure that consultation happens. Honiton is a great hospital. It currently has 18 beds and offers midwife-led births, a minor injuries unit, therapies, outpatients, X-ray and GP-allocated primary care services. It has an outstanding reputation and is often referred to locally as the Honiton Hilton, because it provides such great services. People in Honiton have supported it for generations, and that is what is so essential. We have an ageing population in Devon. My constituency starts in Uplyme. My hon. and learned Friend the Member for Torridge and West Devon (Mr Cox) has Great Torrington in his constituency up in the north-west. Lifton is down in one corner of the county, and it goes right up to beyond Ilfracombe. The county is massive, and it is being suggested that community hospitals should be closed. The Royal Devon and Exeter hospital will be under great pressure to keep its acute beds free. Yet we are closing down community hospitals that could ease the pressure on acute hospitals. That seems to be taking things in totally the wrong direction.

I welcomed the Minister’s intervention on my hon. Friend the Member for North Devon (Peter Heaton-Jones) about the reallocation of funds. Are not the consultations therefore premature? Do they not exclude whole hospitals from being considered at all, and should not that be reviewed? Can the Minister ask for that? The independent health service review looked at the case of Torrington and said that it should not have been closed. As to Axminster, we still do not have a proper facility and we do not know how it will be engaged. Not only are the CCGs taking beds away from community hospitals; they are not putting anything in their place.

I make a plea to the Minister: what are we to do? We have an ageing population; the age profile of Axminster is probably what the whole country’s will be in 2035. Our population is healthy but growing older. We want to help people in their own homes. I am pleased for that to happen, and I think it is right, but we also need community hospitals. Honiton has excellent communications so it is easy to bring people in and out of the hospital, and it is a quick journey from the Royal Devon and Exeter to Honiton hospital if people need to be brought back to relieve the pressure on beds. I cannot see how it is possible to go forward with a consultation when a hospital is completely taken out. I am sure that the Minister will say that it is up to local people and organisations to decide; but there is a problem if, when local consultation comes along, a hospital is removed from the list. Also, when it comes to staffing, it does not help in getting staff for a local hospital if that hospital is threatened with closure.

I really feel that all our MPs across the whole of Devon need to unite, because over the last two years the number of beds in our community hospitals has been halved. I rather fear that we will be standing here in two years’ time saying that they have been halved again. Rather than fighting between each other over which hospitals are kept open and which are closed, let us fight all the closures across Devon. Otherwise we are just being picked off one by one, Minister, and this is not the way to run a health service in Devon.

--- Later in debate ---

[The Minister of State, Department of Health (Mr Philip Dunne)]

I am grateful to you for taking the Chair this afternoon, Mrs Main, and for encouraging me to leave some time for my right hon. Friend the Member for East Devon (Sir Hugo Swire) to respond, which I will endeavour to do. I congratulate him not only on securing this debate, which has been very well supported by his colleagues from across the county, but if I may—this is the first opportunity for me to do so publicly—on the recognition that he received of his time in Government from the previous Prime Minister.

I start by highlighting some of the excellent work carried out every day by all those who work in the NHS, not only in my right hon. Friend’s constituency but in mine and those of all the others who have spoken today. I will attempt to address some of the specific points that have been raised, particularly by my right hon. Friend, but I shall first provide the House with a little context and background regarding health services in Devon.

Devon is a leader in many areas of the health service—perhaps to the surprise of some hon. Members who have spoken—relative to other parts of the country. Not least, the Torbay and South Devon NHS Foundation Trust was the first trust in England to join up hospital and community care with social care. A plea to do that was made by my right hon. Friend and it is already happening in South Devon. The trust operates as a single organisation, working with partners to improve the way it delivers safe, high-quality health and social care. The trust is showcasing exactly the kind of joined-up, patient-centred care that we want the NHS to provide to meet the needs of the ageing population.

I also pay tribute to the staff at the Royal Devon and Exeter NHS Foundation Trust, who last month celebrated their fifth anniversary since the last incident of hospital- acquired MRSA. That remarkable accomplishment comes as the result of continuous improvements at the trust over the last 10 years. The trust is now considered a national leader in infection control, being the only general hospital in the whole of England to have avoided any MRSA infections in the last five years.

However, I absolutely recognise that the region is facing difficulties. NHS staff across the region are working hard to provide good care to patients, but services are not keeping pace with the changing needs of local people. It is becoming increasingly difficult to make sure that local people have access to consistently high-quality care that is affordable and sustainable.

As my right hon. Friend said, in June 2015, NHS England announced that north, east and west Devon would be one of the three areas in the country to take part in a success regime. That is designed to improve health and care services for patients in local health and care systems that are struggling with financial or quality problems. Following intense diagnostic work, the north, east and west Devon success regime published, in February this year, the “Case for Change” report, which was referred to earlier. The report sets out the underlying challenges facing the area and the opportunities to improve access to services and ensure clinical and financial stability. The work concluded that if nothing was done, Northern, Eastern and Western Devon would have a system deficit of £398 million by 2020/21, as has been referenced by a couple of hon. Members, including the hon. Member for Burnley (Julie Cooper).

As well as the financial challenge, the work identified significant health inequalities and some clinical services that will be unsustainable in their current form. There are good reasons for that. As we have heard from hon. Members, people in north, east and west Devon are living longer successfully, particularly in areas of the constituency of my right hon. Friend the Member for East Devon and in Torbay.

People are living with increasingly complex care needs and require more support from health and social care services. More than one in five people in north, east and west Devon are over the age of 65, and that figure will be almost one in four by 2021. Some 40% of local people use almost 80% of health and social care services. There are 280,000 local people, including 13,000 children, living with one or more long-term conditions such as asthma, diabetes, hypertension, cancer and mental illness.

Although Devon is regarded from the outside as generally affluent, we are all aware—hon. Members have explained this—that there are areas of significant deprivation. There are big differences in health outcomes between some areas, particularly in Plymouth. There are also spending disparities between different parts of the county.

More than 10% less for each person is spent on healthcare in west Devon compared with north and east Devon, even when age and deprivation is taken into account, as my hon. Friend the Member for North Devon (Peter Heaton-Jones) emphasised. Somebody living in Ilfracombe Central is statistically likely to die almost 15 years earlier than a person living a two-hour drive away in Newton Poppleford.

Inequalities need to be reduced, and the spread of health and social care across north, east and west Devon needs to be made more equal. I am sure that my right hon. Friend the Member for East Devon agrees that his constituents should have access to the same high-quality healthcare services as those in the rest of Devon, let alone the rest of the country. He referred to the success regime consultation as being at fault. I gently remind him that it was only published on 7 October. I am sure that comments made today about the lack of available paper copies of the consultation will be taken into account by the organisers, and that we can respond to that.

[Neil Parish]

I want to press the Minister on the success regime’s consultation. Is it right for a hospital to have its beds taken away as part of that consultation? Surely a consultation should be for people to have a say on a public decision.

[Mr Dunne]

I heard my hon. Friend mention the lack of reference to Okehampton and Honiton. I gently draw attention to the fact that the option to retain community beds in both those hospitals was considered as part of the 15 options in the document. The option was rejected as one of the four recommended for consultation, but that does not prevent him, his constituents or local representatives in those areas from putting those alternative options forward.

My right hon. Friend the Member for East Devon asked whether there was a “none of the above” option. I think he may have been referring to page 42 of the consultation document, on which the organisers say that they

“welcome all views and will carefully consider all responses and analyse these against the decision making criteria. That will include options which are not currently in the consultation document”.

They are open for proposals to be made by others, but those need to be looked at in the context of the criteria.

Oral Answers to Questions

Neil Parish Excerpts

Tuesday 24th February 2015 Commons Chamber

[Norman Lamb]

If that was the advice the hon. Lady’s constituent received, it is complete and utter nonsense. The idea that someone can have only one episode of care under the NHS is so ridiculous that it hardly merits a proper response. I urge her to encourage her constituent, with her support, to go back to those local services and ensure that she gets further support if she needs it, as she is entitled to it.

[Neil Parish (Tiverton and Honiton) (Con)]

17. What assessment his Department has made of the future role of community hospitals.

[The Parliamentary Under-Secretary of State for Business, Innovation and Skills (George Freeman)]

Community hospitals can play a hugely important role in the 21st-century NHS. The NHS “Five Year Forward View” explicitly recognised the role of smaller hospitals, including community hospitals, as part of the new care models towards which we need to evolve. Specific local commissioning decisions are rightly taken by local clinical commissioning groups, reflecting local need.

[Neil Parish]

We have excellent hospitals in Tiverton, Honiton, Axminster and Seaton, and there could be a much greater link between them and the Royal Devon and Exeter NHS Foundation Trust. For example, patients could be moved to the community hospital in Axminster after acute operations, thereby creating space at the RD and E and keeping Axminster hospital open with beds, which the population is keen to see.

[George Freeman]

I pay tribute to my hon. Friend for his tireless work on this matter. I know that he recently met the Secretary of State to discuss it and that he has been very active locally and here in Parliament. He is right that local community hospitals can play a key role in supporting patient convalescence, providing particularly good care in the community close to home, which is convenient for elderly patients, and relieving pressure on acute hospital beds. You do not have to take it from me, Mr Speaker; take it from Simon Stevens, the chief executive of NHS England. He recently said:

“A number of other countries have found it possible to run viable local hospitals serving smaller communities than sometimes we think are sustainable in the NHS…The NHS needs to abandon a fixation with ‘mass centralisation’”.

I hugely welcome that.

Dementia Care and Services

Neil Parish Excerpts

Tuesday 7th January 2014 Commons Chamber

[Alec Shelbrooke]

I am grateful for the comments that the hon. Gentleman has made. He is right that we must not only treat the illness, but consider what preventive work can be done. I will speak later about the need for the national strategy to focus not only on the treatment of people with dementia, but on what other research can be done.

It is obvious that dementia is on the radar of an ageing society. However, given the emotional toll of dementia and its prevalence at the end of life, I was horrified to hear that only 48% of people who live with dementia receive a formal diagnosis, meaning that many people are denied the care and support that they and their loved ones need. Before the national dementia strategy for England was introduced in 2009, the rate was 33%. If further proof were needed that dementia care and services need to be improved as soon as possible, those awful diagnosis rates should be enough to show that something needs to change.

I am proud to be part of a coalition Government who have shone a long-overdue light on dementia, not least through the Prime Minister’s decision to host the G8 summit on dementia last month. However, there is still much to do before we can be confident that everyone who is living with dementia—individuals and families—is able to have a fulfilled life.

[Neil Parish (Tiverton and Honiton) (Con)]

It is good that my hon. Friend has secured this debate. It is not only the people who are suffering from dementia who are badly affected, but those who are looking after them. We must therefore not only get the diagnosis right for those who are suffering from dementia, but ensure that there is respite care for those who are looking after them. They need a break in order to fulfil their caring role properly.

[Alec Shelbrooke]

I am most grateful to my hon. Friend for those comments. I am sure that everybody has experiences of their own, but perhaps it will help the House if I speak about my grandmother, as I did earlier. I was aged about 12 or 13 at the time of her diagnosis, and my sister was two years younger. My dad was working as a teacher and supporting me, my mum and our family, but he was also dealing with his own mother. I remember the toll that that took on him. He had to work out what was the best thing to do for his mother. He toiled over the decisions that he had to make for a long time, such as selling the family home in which he had been born and brought up in order to raise money for the care home. My hon. Friend is right that there is a massive toll on the families involved, as well as on the people who have this terrible disease.

Despite the focus on dementia, there is a danger that the momentum that has been created by the Prime Minister’s challenge on dementia, the G8 summit and the work of the Science and Technology Committee and the all-party parliamentary group on dementia will be lost if the Government do not act in a number of areas.

Brain Tumours in Children

Neil Parish Excerpts

Tuesday 3rd September 2013 Westminster Hall

[Mr Dominic Raab (Esher and Walton) (Con)]

Thank you, Mr Sheridan, for calling me to speak; I believe that this is the first occasion that I have spoken under your chairmanship.

I have to say that on this particular topic I come as something of a novice. I was regrettably unaware of many of the basic facts about children in Britain who are afflicted by brain tumours until recently, when I was approached during the summer by a constituent, Anne Pickering, who is here in Westminster Hall today. On a family holiday to the Isle of Wight in 2008, Anne’s daughter, Charlotte, collapsed on a beach as a result of a brain haemorrhage. Charlotte was rushed to Southampton general hospital. She underwent surgery, she remained on life support for 10 days and she lay in a coma for five weeks. Later she spent five months in rehabilitation at the amazing Children’s Trust in Tadworth and this courageous young woman, who is now 16, has made a full recovery.

I should say at this point that I have been down to the Children’s Trust to see for myself the incredible work that it does. Witnessing the tenacity of children with serious brain injuries from tumours, haemorrhages and various other illnesses making the long, hard and often uneven road to recovery is like watching someone crawl a marathon, inch by inch. It is nothing short of heroic—both heartrending and uplifting at the same time—and what is achieved at the Children’s Trust is quite something to behold.

However, the truth, of course, is that not all such stories end as well as Charlotte’s did. During Charlotte’s treatment, her mum Anne met Sacha Langton-Gilks, whose son, David, was fighting a brain tumour that had been diagnosed late. Despite David’s herculean efforts, he died aged 16. All anyone has to do is to google his name to read the many accounts of this lad’s epic bravery. David was diagnosed with a tumour the size of a golf ball on 24 October 2007. He struggled for nearly five years, through chemotherapy, radiotherapy and a stem cell transplant, stoically refusing to give up on life, whether it was reading up on Buddhist philosophy or tobogganing in the snow with his brother and sister. The term “inspirational” does not even begin to do this young man justice. Very sadly, David died on 14 August last year, but not before he stood up in front of the full glare of the national media, despite his terminal diagnosis, in a valiant effort to raise awareness of the prevalence of brain tumours in children, in order to save lives.

[Neil Parish (Tiverton and Honiton) (Con)]

It is great that my hon. Friend has been able to secure this debate. Early diagnosis is vital, and there are charities such as the Brain Tumour Charity, which runs the HeadSmart campaign, and others that are working along with the Government to try to ensure that professionals are aware of brain tumours at a very early stage, because the sooner they can be found the sooner people can be cured. I have constituents who have been affected by tumours.

[Mr Raab]

I thank my hon. Friend for that intervention. He is absolutely right, and what we must do is to keep pushing the HeadSmart campaign to move it along even further.

Dementia

Neil Parish Excerpts

Thursday 10th January 2013 Commons Chamber

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

My hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) hit the nail on the head when she made the point that everyone knows somebody who has been affected by dementia or some form of Alzheimer’s. I have a stepmother who is very elderly now—she is 93 and is in a home. The last time I went to see her, she was woken up and she looked at me, squawked and went straight back to sleep again. That is very sad—it is incredibly sad—for one simple reason. This was a woman who got a degree at Oxford in 1938, at a time when women did not get degrees. She then became an interpreter at Bletchley Park during the war and played a significant part in defending our country from Nazi oppression. For her to be in that position now is very worrying and concerning for all of us. I very much hope that she continues to have an acceptable life, and I am delighted that everyone there is most certainly going to be helpful.

I pay tribute to the hon. Members for Bridgend (Mrs Moon) and for Oldham East and Saddleworth (Debbie Abrahams), who must have found it very difficult to talk about their personal lives and experiences. I commend them both for being able to do so in this environment and for getting through it. May I also say what an honour it is to share a platform in this debate with the hon. Member for Plymouth, Moor View (Alison Seabeck)? I suspect that, between us, we will find ourselves repeating each other somewhat, although I am in the fortunate position of going first.

The issue of social care is becoming increasingly important. There has been an enormous amount of press attention on how people are cared for in the latter years of their lives. However harrowing the stories may be, they provide us with an opportunity to speak about social care and lessen the stigma that surrounds death and dying. Dementia is already a significant issue and a growing concern that should not be ignored.

I am delighted to say that I represent a constituency in a part of a city that has a really good reputation on dementia, especially through the university. An enormous amount of research is done; indeed, I am for ever getting telephone calls from Ian Sheriff—for whom I have an enormous amount of time—who rings me up and gives me advice on how we should handle this issue. However, I was surprised to find out that there are currently more clinical trials into hay fever than into some common forms of dementia. So I heard that our mutual friend the Health Secretary had announced that spending on dementia research would receive a £22 million cash injection I was incredibly grateful. More funding will most certainly need to be made available to excellent bodies around the country such as the Alzheimer’s Society and to universities such as Plymouth.

Plymouth university conducts a great deal of research into dementia and this policy area. In September the university held a very good conference, which it asked the Prime Minister to attend. Unfortunately he could not come, but we will see whether we can have another go later. Any help that the Minister, my hon. Friend the Member for North Norfolk (Norman Lamb), can give to encourage the Prime Minister to come and participate in the dementia conference would be helpful. Indeed, his lead in the dementia challenge has given the whole thing an impetus. The university also does a lot of work on community engagement and raising awareness. Indeed, shortly after Christmas I went to Stoke Damerel community college, which has done a lot of work on encouraging youngsters to become more involved in community engagement with dementia. May I also pay tribute again to HMS Drake, which is taking a big lead on dementia and ensuring that this happens elsewhere in the Ministry of Defence?

In Plymouth there are around 3,200 individuals with dementia. That figure is forecast to rise by 35% in the next 10 years, but this is just the beginning. The diagnosis rate is 39%, which it is estimated will increase by 27% before 2021. That means that a large number of people in my constituency do not have access to the care and support they need on a daily basis. The new NHS mandate commits to drive up diagnosis, which can only be a good thing for both sufferers and their families. I know that the Government want the clinical commissioning groups and the NHS Commissioning Board to work together on that aim, and I would welcome more information from my hon. Friend the Minister on what plans are in place to ensure that that happens, so that the lives of sufferers and their carers can improve.

GPs are on the front line when it comes to driving up diagnosis rates. They express their concern about mistaking the symptoms of dementia for old age. In some cases, they do not make a diagnosis of dementia because they feel that to do so is futile. I am aware that the Department of Health has put the case for a reward through proactive case finding, which is due to be consulted on this year. Is there a timetable for that consultation to begin? The sooner we start to diagnose those in need, the sooner we can start to help them.

Earlier this week, I participated in a debate on the Liverpool care pathway. We had an interesting discussion, and real concerns were raised. I told a story about a constituent who came to see me about her father. It had been decided to put him on the Liverpool care pathway, but the family were concerned because they knew nothing about that until they were told about it by one of the car park attendants at the hospital. The process was supposed to last for two days, but it went on for 12 days, and the family were very concerned about that. Will my hon. Friend the Minister have another look at that issue, just to make sure that such cases have been included in the review of the LCP?

A number of excellent facilities exist around the country, especially in Plymouth, and I want to pay tribute to St Luke’s hospice, and to the hospice movement in general, for doing a tremendous job. They are certainly appropriate places for people to spend the last few days of their lives. Given that the report on Stafford hospital is to be released shortly, however, it is clear that dementia sufferers often do not have the dignified death that we would expect for them. I am aware that we are all mortal, although I have wondered whether God might make an exception in my case, and whether I might be here for ever and a day. I know that that is not going to happen, however.

It is important to ensure that, when dementia sufferers die, they are able to do so with dignity and without pain. The more work that we can do to ensure that that happens, the better. Vulnerable people need to be properly looked after, as do their carers. We need to ensure that we talk to the relatives as well, to ensure that they understand the processes involved. None of us—politicians or anyone else—likes to be ambushed, and it is important to help those family members to work their way through their suffering as well.

[Neil Parish (Tiverton and Honiton) (Con)]

My hon. Friend is making some good points. Those who care for dementia sufferers need respite care, but we do not always provide for that as well as we should. I am keen to see more respite care being provided for those who care for people with dementia.

[Oliver Colvile]

I agree with my hon. Friend. This is also about the families, who have to deal with dementia on a daily basis.

Given the appalling events at Stafford hospital, appropriate checks and balances must be put in place to ensure that people with dementia are given the proper quality of care in all hospitals. Further, it should become standard practice that the demands of someone with dementia should be listened to. It is incredibly important that we get better at listening to what they, and their families, are saying. Dementia is a complex illness, and it is often difficult to assess its onset. Whenever possible, however, conversations should be held with the individual and their loved ones about what is happening and the process that is involved. Such conversations would be useful in helping the family through the process.

Dementia is now one of the top five causes of death in the United Kingdom, and it is disappointing that the health and wellbeing boards are being a little slow to consider people’s needs. About 800,000 people in the UK have dementia, and that number is going to go up. It is said that more pressure is being put on the national health service. I do not think that is right. I think that we are making enormous strides in order to deliver better health care for our elderly. It is because we want to do more that our national health service is facing increasing levels of challenge.

For those with dementia, the changes to long-term care are crucial. I am delighted that the Government are looking at trying to take forward the Dilnot report, to which I made my own submission—I have a copy here or I could e-mail it to the Minister. That report must be viewed as a blueprint for how to go forward.

There has been increasing debate with the Treasury since the 1940s. Let me remind everyone of what happened in 1947 when the national health service, of which we are all very supportive and proud, was first set up. The other half of the equation was long-term social care. Over the last 10 or 15 years since I was a candidate for Plymouth, Sutton as it then was—it is now Plymouth, Sutton and Devonport—I have spoken about the divorce of social care from the national health service. If I have a heart attack or have cancer, I will have to deal with it one way, but if I have Alzheimer’s, Parkinson’s or dementia, it will be considered to some extent as being a separate challenge. I believe that we need to bring the two much closer together.

I have some concerns about using insurance. Every time I have had to make claims—on my car insurance, for example—I have always had some difficulty with my provider. We need to look at that, but we need to ensure that people do not see all their savings just disappearing into a black hole. That is something that we need to deal with as a country. There is a danger that the amount of money individuals are asked to pay for their care will remain far too high. We cannot hide from that in our ageing society.

At the beginning of my time in the House, I wrote a paper on the strategic defence and security review, in which I said that there were two important matters of which we needed to take notice. The first was that more money needed to be put into defence—I continue to say that—but the second was that we should devote more money to long-term care for the elderly. That was my No. 2 priority; it has to be incredibly important.

I welcome the Government’s decision to take on the global health challenge—a priority after years of neglecting this growing problem. I welcome the Prime Minister’s commitment and the leadership and extra support he has provided for people with dementia in carrying out their everyday tasks. That shows a shift in the wish to combat the stigma that surrounds dementia and to achieve greater awareness of the illness. We need to learn, too, from the ethnic minority communities that tend to work much more closely together with their families in providing care.

--- Later in debate ---

[Sarah Newton (Truro and Falmouth) (Con)]

I listened with great pleasure to my hon. Friend—I hope I can call her that—the hon. Member for Worsley and Eccles South (Barbara Keeley); I have the privilege of serving as her deputy on the all-party group on social care. I wish to echo the point she has just made, which was also so well made by my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch), who played such an important role in securing today’s debate.

This is a very important occasion for us to show the collective will of hon. Members—there are so many here today—to hold the Government’s feet, and indeed the Opposition’s feet, to the fire. We need urgently to come to an all-party agreement on how to fund properly the future of care and social care in our community. I also wish to thank the right hon. Member for Salford and Eccles (Hazel Blears) for her contribution. I am sure that she will indulge me as I thank the chair of the all-party group on dementia, Baroness Greengross, who has dedicated her whole life, both in the other place and outside Parliament, to raising issues affecting older people, their families and carers so well. I thank the right hon. Member for Salford and Eccles for her part in securing this debate, which gives us such an important opportunity to de-stigmatise dementia and other mental illness.

I remember only too well that when I was a child growing up people would not talk about cancer; it was whispered about or called “the C word”. Thankfully, we can now openly talk about cancer, which is to the great benefit of sufferers, their families, their loved ones and their carers. We must quickly move to the same position for people suffering from dementia, Alzheimer’s and a range of other mental health conditions.

[Neil Parish]

I agree very much with my hon. Friend that cross-party support on how to provide long-term care for people with dementia is essential, because our population is ageing. Better medical care means that people are living longer, but of course it also means that we will have more people suffering from dementia. It is right that we accept that situation as being part of society and as something we must deal with, but we must have a way of providing the funding so that we do not take away everybody’s assets to pay for treating dementia.

[Sarah Newton]

My hon. Friend makes his point well. I know that other hon. Members have very worthwhile points to make, so I do not wish to take up too much of the limited time available. However, I wish to make just a few points about how we in Cornwall are rising to the Prime Minister’s dementia challenge. It is right for us to set strategies nationally and to agree nationally on the overall frameworks to tackle one of the greatest challenges of our century. However, it is also important to look for the solutions locally. We should set the strategies nationally but enable everybody in communities around the country to come together to find their solutions. As the right hon. Member for Sutton and Cheam (Paul Burstow) rightly said in his opening remarks, we will all have to rise to the challenge. Every single part of society and every part of the public sector has its role to play. Indeed, as my hon. Friend the Member for Chatham and Aylesford said, the private sector, including supermarkets and other organisations in the public domain, has an important role.

What have we done in Cornwall of which I am so proud and which I want to share with right hon. and hon. Members? Let us start with the NHS, because when people seek a diagnosis that is where they start off on their journey with dementia. We have set up the Kernow clinical commissioning group, which is very successful and has got off to a flying start. It has attracted a large sum from the dementia challenge—well over £500,000. What is it doing with that money? It is working very effectively in partnership with other parts of the public sector, voluntary organisations and other parts of the NHS to ensure that there is an integrated, joined-up approach in Cornwall.

The CCG has targeted an issue mentioned by many Members, which is the need to ensure that everybody working in health and social care is properly trained, from carers through to doctors and nurses in the acute sector, to ensure that they are aware of dementia and how to talk to and relate to the people with this condition with whom they come into contact, as well as their families, friends and informal carers. The group is also using the money to ensure, among other things, that from the moment of diagnosis of dementia through to the end of life, sadly, there is a named individual available for that person and their family and carers. Obviously, it is early days as it just got the funding in November, but its ambitions are very important and will make a real difference to the quality of life of families in Cornwall.

Another issue that has been mentioned today is the lack of care from some nurses in parts of the acute sector. I want to share with hon. Friends a great initiative in the Royal Cornwall hospital, which is our only acute hospital in Cornwall. The friends of the Royal Cornwall hospital, who have worked so well with nurses, doctors and managers over a long period, are addressing some of the issues raised today. They have a very good system of mealtime companions, specially trained volunteers who work alongside care assistants and nursing staff. When the staff are too busy, they provide the extra time, care, compassion and consideration that needs to be given to a range of patients, including those with dementia, to ensure that they have a drink and something to eat. The hospital is also open to family members and others at mealtimes. I recommend that hon. Friends take that issue up with their hospital trusts and use the example of Royal Cornwall, which has clearly found a way around the problem.

The voluntary sector and society as a whole will have a hugely important part to play. Like many other hon. Members who have spoken, I am involved with the memory café in my constituency, in Falmouth. There are 24 other memory cafés in Cornwall and they are really important. People with dementia and other memory loss conditions, their families and their carers can come along to a safe, supportive environment, have some fun and do some interesting activities, talk to each other and get information. That is very important.

In Cornwall, we are fundraising for Admiral nurses. Those Members who have Admiral nurses in their constituencies will know the very important work they do to support families in much the same way as Macmillan nurses support cancer patients and their families. Admiral nurses provide an invaluable service for people with dementia and I shall be working hard alongside those who are fundraising so that we soon, I hope, have Admiral nurses in Cornwall.

I could talk about a lot of things, but for the sake of brevity let me simply say that many of the activities I have mentioned must be co-ordinated and planned. I want to reassure my Opposition colleagues that that is possible. Our health and wellbeing board in Cornwall has got off to a really good start. It works very closely with public health providers and all the different parts of the community, from housing to environmental health, to pull together a strategy for dementia and turn the good ideas and aspirations into action. I see the reforms to the NHS giving a great deal of power to doctors, other health professionals and people across the public sector to come together to work in partnership to deliver local solutions that work for communities. Salford is quite different from Cornwall and we all need to work together to find what works in our communities.

A great deal of good work has been going on in Cornwall and will continue in years to come, but I am not complacent. We are a part of the country with a fast- ageing population and have yet to find ways to diagnose dementia accurately. We have some of the lowest levels of detection of dementia. I will work hard with colleagues in Cornwall in all sectors to drive that up.

Hospital Food (Animal Welfare Standards)

Neil Parish Excerpts

Wednesday 12th December 2012 Westminster Hall

[Neil Parish (Tiverton and Honiton) (Con)]

I am grateful for the opportunity to discuss this important issue, and I thank you, Mr Turner, for allowing me to open the debate, in which I will call for the introduction of mandatory animal welfare standards for hospital food in England. It is a pleasure to do so under your chairmanship. As many hon. Members know, I am passionate about animal welfare, and I am both a proud member of the Select Committee on Environment, Food and Rural Affairs and the chair of the associate parliamentary group for animal welfare.

It may come as a surprise to many that the food served to patients in NHS hospitals in England need not meet mandatory animal welfare standards. Currently, Government buying standards are mandatory only for central Government buying departments, the Ministry of Defence and prisons. Schools and hospitals, which are excluded from the buying standards, account for 70% of public sector spending on food, meaning that prisoners currently have a guaranteed minimum standard but patients do not.

The welfare standard provided for animals reared for food is undoubtedly important, especially for animals reared for food bought by the taxpayer and served in public institutions such as hospitals. The animal welfare quality of food bought by hospitals in England varies widely, yet patients throughout the country deserve to eat food produced to the same high standards. We need a consistent approach to tackle the situation.

Animal welfare standards for hospital meat, dairy and eggs are subject to a postcode lottery. The programme for Government stated that the coalition Government would promote high standards of farm animal welfare, and it is important that public bodies set an appropriate example by ensuring that their purchasing policies are in line with that objective. Unfortunately, research published by the Campaign for Better Hospital Food and the Royal Society for the Prevention of Cruelty to Animals reveals big regional differences in animal welfare standards for hospital food in England.

The research discovered a number of shocking findings: 71% of eggs bought by hospitals in England are laid by caged hens, and only 39% of eggs bought by hospitals in the south of England are cage-free. Only one in four eggs in the north of England, and only one in every six in the midlands and east of England, are cage-free. We can see how much it varies in the postcode lottery. The report also revealed that 86% of chicken and 80% of pork bought by hospitals is not certified to meet RSPCA welfare standards. The figures paint a sad and regrettable picture of the welfare standards for animals reared to provide food for our hospitals. Chicken, pork and eggs that have not been produced to RSPCA welfare standards are likely to come from animals that have not had a good quality of life. Government attempts to set animal welfare standards using voluntary measures have failed, which is why I am calling for a statutory solution.

Concerns about the quality of hospital food, including its animal welfare standard, are not new. A report by Sustain, the alliance for better food and farming, estimates that in the last 20 years, the Government have spent more than £54 million of taxpayers’ money on issuing guidance to hospitals encouraging them to improve the quality of the food that they serve, including the animal welfare standard of its production, yet the research by the RSPCA and the Campaign for Better Hospital Food shows that the guidance has had a disappointingly weak effect.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing the issue to the House. Although it is important to improve animal welfare standards not only in England and Wales but in Northern Ireland and Scotland, he will be aware of the oft-stated comments about hospital food by patients and people who visit hospitals. Does he feel that improving animal welfare standards will also improve the quality of hospital food? That must be a good step.

[Neil Parish]

The reason why I talk about England is that the food served in hospitals is a devolved matter. However, it is still important for Northern Ireland. I am keen to get good animal welfare standards, and I believe that that will help with the quality of meat and eggs served to patients. The two are linked. I believe that most production in the UK and Northern Ireland meets high standards, and I want to ensure as far as is practical that that is the sort of food served in hospitals not only in Northern Ireland but across England as well.

[Mr Andrew Smith (Oxford East) (Lab)]

I congratulate the hon. Gentleman on securing this important debate, and I agree with the thrust of his argument. Does he agree that there are lessons to be learned from good practice in the NHS? My mum recently had quite a long stay in West Berkshire community hospital, and no praise is high enough for both the standard of care and the standard of food there. Knowing that this debate would be taking place, I asked the hospital about its sourcing, and it said:

“The food supplied to our restaurant is mainly from national suppliers that have been through a rigorous supplier accreditation process, using British-produced meat. Our Chef Manager on site, however, is very skilled in ensuring only the best but most cost-effective ingredients are used in his menus and, where possible, uses free-range meat in the restaurant.”

Does that not show that high standards of supply, value for money and good hospital food can go hand in hand?

[Neil Parish]

I thank the right hon. Gentleman for that intervention. In a minute, I will comment on various hospitals. He shows that hospitals can deliver high welfare standards, source a lot of their meat and egg products nationally and serve up good-quality meals, and that it can be done on a reasonable budget. The other argument is that the hospitals will turn around and say, “We only have a limited budget, and we have got to make it go a long way.” However, some hospitals manage to get a good deal and good welfare standards, and then produce good food.

I emphasise that I am not here to knock hospitals and the NHS. I only want to improve the welfare standards for the meat and eggs served in our hospitals. Our health service does a very good job, but sometimes—dare I say it—patients might like slightly tastier meals when in hospital. It would certainly improve our view of life, even if it does not cure us instantly. It can have a positive effect.

During the same period, in stark contrast, setting mandatory standards for food served in other public institutions has proved highly successful. For example, the introduction of mandatory school food standards by the Government in 2005 led to a dramatic improvement in the quality of school meals, ensuring that children who opt for them get healthy, tasty and varied options. The introduction of mandatory nutritional standards for food served in Scottish hospitals in 2008 and Welsh hospitals in 2011 resulted in a significant improvement in the healthiness of patient meals, and it has been at the forefront of the Scottish and Welsh Governments’ efforts to tackle the effects of poor diets on health, particularly in relation to heart disease, stroke and type 2 diabetes.

Although the introduction of mandatory food standards worked in those settings, the use of voluntary guidance for hospital food has not succeeded to the same degree. Hospitals in England spend a third of their food budget and £167 million of taxpayers’ money every year on meat, dairy products and eggs. Approximately £1 in every £4 spent on hospital food in England is spent on meat, and approximately £1 in every £10 is spent on dairy. That represents a vast amount of public expenditure, which the Government can use to ensure that taxpayers’ money is invested in rewarding farmers who have adopted ethical farming practices rather than those rearing animals in unacceptable conditions.

It also helps to ensure that most of the meat, eggs and dairy produce that feeds patients in hospitals is sourced from Britain, and locally, I hope. Some hospitals are proving that it can be done on budget. A handful of NHS hospitals in England already only serve food that meets the animal welfare standards I am advocating, proving that doing so is both practical and affordable. For example, Nottingham University Hospitals NHS Trust, and Braintree community hospital and St Margaret’s hospital in Essex, have all been—

[Bill Wiggin (North Herefordshire) (Con)]

Will my hon. Friend give way?

[Neil Parish]

I certainly will. I knew it was a mistake to pause.

[Bill Wiggin]

I congratulate my hon. Friend on securing the debate. I hope that my intervention gives him an opportunity to find his place in his speech.

My hon. Friend will have read the excellent speech about care made by the Secretary of State for Health. Does he not agree that this is the perfect opportunity to increase the quality of food for patients while delivering top-quality care for them? It is a win-win situation for the Government, if they follow my hon. Friend’s argument.

[Neil Parish]

I thank my hon. Friend for his intervention, which gave me the chance to find my place in my speech. I agree with him. Before he arrived in the Chamber, we were making the point that food produced under high welfare standards has the benefit, in many cases, of being that bit tastier for patients. We are also asking for a slightly more varied menu—dare I say it—in some hospitals, because that will be the key.

I re-emphasise that I am not criticising hospitals and the NHS in any way. I am asking them to use the good practice that many hospitals are providing throughout the country. We need many more hospitals to do that.

All eggs served by the hospitals I mentioned before my hon. Friend’s intervention are cage-free, and those hospitals will be working to improve the animal welfare of their food, including serving chicken and pork that is either organic or meets RSPCA welfare standards. Nottingham University Hospitals NHS Trust spends less on its higher welfare food than other hospitals spend on food reared to low or no standards of animal welfare.

Hospitals that have been given a Good Egg and a Good Chicken award by Compassion in World Farming for buying RSPCA welfare chicken, pork and cage-free eggs include the Royal Marsden NHS Foundation Trust and the Royal Brompton and Harefield NHS Foundation Trust in London, York Teaching Hospital NHS Foundation Trust, North Bristol NHS Trust and Scarborough and North East Yorkshire Healthcare NHS Trust. I should probably have included West Berkshire community hospital, and I shall ensure that I do so next time. Although those hospitals show what can be achieved on an NHS budget, the standards they have achieved have not been replicated throughout the country, despite one in every 10 patient meals being thrown in the bin. Mandatory standards are needed.

Hospital food should reflect the ethical concerns of the British taxpayer. The introduction of mandatory RSPCA welfare standards for hospital chicken, pork and cage-free eggs is an affordable way to ensure that chickens, pigs and hens that have been reared for patients’ meals are given a good quality of life. It would also ensure that hospital food reflects the ethical concerns of British shoppers who, in a report by the Department of Environment, Food and Rural Affairs last year, specified that the welfare of chicken, pigs and hens was an increasingly important influence on their purchasing habits. The report found that 75% of UK households said that the animal welfare standards of egg and chicken meat production is an “important issue”, 65% of households “actively seek” higher welfare eggs, and 50% seek higher welfare chicken when shopping. The increase in sales of RSPCA Freedom Food pork by a staggering 116% in 2010-11 also shows that a growing number of consumers consider pig welfare to be an important issue.

RSPCA welfare standards ensure that animals reared for food have been cared for and live a good quality life. It sends the right signal to the farming community, which is keen to have high animal welfare standards and wants to encourage people to pay that little bit extra for production, because there are extra costs for extra welfare. Again, this needs to be brought to people’s attention.

RSPCA accreditation ensures that food has been produced from animals that are reared to welfare standards exceeding legal minimum requirements and guarantees that they are cared for and enjoy a good quality of life. Farm animals reared to RSPCA welfare standards are provided with space to move around, comfortable places to rest, an interesting enriched environment that allows them to express natural behaviours, good health care and ready access to appropriate feed and water. The standards cover large and small farms and animals that are reared outside and indoors. The standards exclude some of the worst farming practices that are still allowed even here under UK law, including the use of so-called enriched poultry cages for egg-laying hens—these are quite controversial—which provide each hen with less usable space than an A4 sheet of paper. The standards also prevent producers from rearing chickens that are genetically selected to grow quicker, and forced to live in crowded and dark conditions.

To protect pigs, the standards prohibit farmers from keeping them on slatted or concrete floors and putting pregnant pigs in restrictive farrowing crates both before and after they give birth. Sometimes there can be an argument for putting a pig in a crate during birth, just to save the piglets, but certainly not afterwards.

As hon. Members may have seen in the supermarket, all meat, dairy products and eggs produced to RSPCA welfare standards are approved by the RSPCA’s Freedom Food assurance scheme, as shown by the logo on the packaging. Hospital food that meets RSPCA welfare standards is good value and affordable for caterers. Although RSPCA Freedom Food-certified chicken, pig meat and cage-free eggs may cost more than alternatives produced from animals reared to no welfare standards, they remain affordable for hospitals. In fact, figures from the retail sector show that RSPCA Freedom Food chicken, pork and cage-free eggs can sometimes be cheaper. For example, RSPCA Freedom Food barn eggs from Sainsbury’s cost the same as cage eggs from Tesco and Asda. I am not promoting different supermarkets. Sainsbury’s RSPCA Freedom Food chicken thighs and drumsticks are 22% cheaper than Sainsbury’s chicken and thighs that meet farm-assured standards.

The overall picture shows that hospitals can expect to pay more for food that meets RSPCA Freedom Food standards, but not by as much as we might think. Paying more money for a higher standard of welfare is a price worth paying.

To recap, substantial benefits would be achieved by introducing mandatory RSCPA welfare standards for hospital chicken, pork and eggs. Those standards would end the postcode lottery in the animal welfare standard of hospital meat, dairy and eggs, in which some hospitals serve much higher quality products than others, and would ensure that patients can be confident that good animal welfare production processes are used in all hospitals, in whatever part of the country. Taxpayers’ money would be invested in rewarding British farmers who are producing great food to high standards of animal welfare, and there would be a guarantee that hospital food meets the standards that many Britain consumers actively seek when shopping for themselves. Hospital chicken, pork and eggs would be served with clear information about the animals used to produce the food and where it is reared.

We can work together now, providing good food for patients in hospitals and ensuring that it is produced to high welfare standards. I am keen that farmers who produce high-quality food to high welfare standards have a market for their food, so that we encourage the right kind of production. There is a win-win situation for the Government in ensuring that they target taxpayers’ money on buying higher welfare standard food, making sure that patients in hospitals have good quality food to eat, and ensuring that farm production in this country carries on to meet the high welfare standards that the public at large expect of farmers. I look forward to the Minister’s comments.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

It is a pleasure to serve under your chairmanship, Mr Turner. I pay tribute to my hon. Friend the Member for Tiverton and Honiton (Neil Parish) for securing the debate and for his ongoing keen interest in ensuring the highest standards of animal welfare in farming and food production. We know how important that is because we both represent rural parts of the country, although I have a slightly more mixed constituency than he does, with a strong urban component. It is always in consumers’ interests for the quality of production to be high, and we do what we can to protect and support our food producers and farmers. We know that to be true, and it is something the Government take seriously.

My hon. Friend will be pleased to hear that, earlier this week, I met and discussed this matter with James Martin, a fairly well known—I recognised him—television chef. I am encouraged by the fantastic work that he is doing to raise the quality of food in hospitals throughout the United Kingdom, but particularly in parts of the north of our country. As a doctor as well as a Minister, I know how important it is that we always provide patients with high-quality nutritious food; it is especially important when looking after older patients, who need to receive high-quality nutrition as part of their recovery. That is precisely why my right hon. Friend the Secretary of State for Health has been so keen, early in his tenure, to support both high quality and dignity in care for older people, and to make sure that as a Government we actively promote greater consistency among hospitals in the provision of high-quality nutritious food and good buying standards.

It is worth outlining what the improving hospital food project is about. Good food is an essential part of hospital care, improving both patients’ health and their overall experience of their stay. Clinicians have a duty to ensure that patients get the right treatment for their condition, but it is also important that patients receive the right supportive care to enable a good recovery, and nutritious food is essential. Catering to everyone’s taste can be a challenge, and there are many ways to produce good food in hospital. It is right that local hospitals have the flexibility to decide which method is best for them in the context of the needs and preferences of their local population. People in Bradford or Liverpool will obviously have different preferences from people in more rural areas—demographic mixes and tastes differ. I am sure that my hon. Friend agrees.

Our improving hospital food project highlights eight fundamental principles that patients should expect hospital food to meet. One is that Government buying standards for food and catering services should be adopted where practical and supported by procurement practices. The standards cover nutrition, sustainability and animal welfare—the issue my hon. Friend rightly raised in today’s debate. They apply to all food procured by Departments and their agencies and came into force for all new catering contracts from September 2011. They are not mandatory for the NHS, as he said, but via the improving hospital food project, we are strongly encouraging hospitals to adopt them.

[Neil Parish]

I can understand that the Government are slightly reticent to bring in mandatory controls, but are they going to monitor the provision of good food in hospitals? Will they keep an active eye on whether the situation is improving with contracts and whether the higher welfare standards for meat and eggs are being used? They need to monitor the situation, not just bring in a system.

[Dr Poulter]

Indeed. We are looking into that at the moment, with a committee and working party looking at how to roll out good practice.

If we have a mandatory system, we may stifle the potential of what we are seeing locally under the current system. My hon. Friend has highlighted many examples of good practice, and I could add to them: in Sussex, there is a good programme, from plough to plate, which is managed by the head of catering there, William McCartney; and there are other good examples in Nottingham and Scarborough. Local innovation is driving up standards, and that happens in different ways in different parts of the NHS. One of the fundamental principles in which we believe, and it has always been thus, is that hospitals are able to determine how they respond to local conditions. Only this Government have taken seriously the need to support and encourage local innovation better. Through the approach that we have adopted and my right hon. Friend the Secretary of State’s interest in promoting good food in hospitals, we are now seeing many examples of local innovation driving up standards in local hospitals, and through such innovation we can identify and spread across the NHS better and good practice. The problem with a rigid framework or set of criteria is that it might stifle local innovation that can improve standards, as we have seen elsewhere in the NHS.

Our approach is for central Government to take an active interest in good hospital food for the benefit of patients, working through commissioning for quality and innovation payments. To promote good practice, the project is developing an exemplar pay framework within the CQUIN scheme, which enables health care commissioners to reward excellence by linking a proportion of providers’ income to the achievement of local quality improvement gains. We are developing two new CQUIN exemplars related directly to hospital food, one linked to the adoption of Government buying standards for food and one to excellence in food service. I hope that my hon. Friend is reassured by the fact that animal welfare is part of those standards. We are looking at linking CQUIN payments in the NHS to good, ethical Government procurement. We recognise and value the local innovation of various hospital food schemes, which have benefited patients from Scarborough to Sussex. That is better than a rigid framework and enables the NHS to learn from examples of good practice.