Young Adults with Spinal Injuries

Debate between Nigel Evans and Helen Whately

Thursday 29th February 2024 Commons Chamber

[The Minister for Social Care (Helen Whately)]

I thank the hon. Member for Dulwich and West Norwood (Helen Hayes) for securing this debate and for her powerful speech telling us about Tom Lazarides’s experience, his tragic accident and his injury. I welcome his family, who the hon. Lady said are here in Parliament today. I offer them my sincere condolences on the loss of Tom, who sadly died in November 2023.

I listened carefully to the hon. Lady’s speech, although I did not have advance sight of her comments, and I will do my best to respond. I assure her that I am happy to write to her with further details about the points she has raised this afternoon. I am responding as the Minister with oversight of continuing healthcare and discharge, so I will be able to say more on those points. Particularly in her summing up, she talked more generally about care for people with spinal injury, which can have such a devastating impact and can mean that a person needs a great deal of care from multidisciplinary NHS teams.

I could go into the way NHS England commissions services for spinal cord injuries—there is a national specification and a range of support—but I think I could make better use of the time today by picking up on the question of continuing healthcare and the discharge situation, which the hon. Lady outlined. She described how Tom’s family feel that the system failed him and his clearly complex health needs as a result of his injuries. She described the long time he spent in hospital and the long-term rehabilitation he needed, which meant he needed significant ongoing clinical care. She described how he was considered for continuing healthcare and the experience of the eligibility assessment, and how Tom and his family felt it did not take into account his injuries and health conditions, and did not take full account of his medical records. She described how he and the family were then told that he was not eligible. They subsequently and rightly appealed, and I heard how difficult the hon. Lady said that process clearly was for the family and for Tom, with the lack of transparency, the uncertainty, and the feeling that meetings happened without them and their involvement. I heard how Tom felt under pressure to move into a care home, when he really wanted to live well at home. All of us can completely understand that. Anyone, whether a young person such as Tom or someone of old age, wants to live as independently as possible, whatever their health needs at home. I also heard about the experience with discharge to assess.

Clearly, a process is in place for accessing NHS continuing healthcare. The intention of the process is to consider the individual’s clinical needs, the combination of those needs and how they come together, and therefore to assess whether somebody is eligible. The intention is to design a package of care around the individual to support them where they wish to live, be it at home or in a care home. First, a checklist is used, which leads to someone having an eligibility assessment. If I understood it correctly, Tom experienced and went through the eligibility assessment, but, as the hon. Lady mentioned, the initial decision was that he was not eligible. I am happy to make some inquiries. As a Minister, I cannot make a call on any particular decision that is made on an individual, but clearly I want always to be assured that the right process has been followed. It is probably helpful if, with the help of officials, I try to seek some further information outside the Chamber from the hon. Lady to see what I can do to understand fully what happened and to be assured as to whether there is anything we need to do to make the process work better, particularly in the circumstance that she has described, where somebody such as Tom has clearly had some severe injuries. I am also happy to meet her and Tom’s family to understand this process better.

The hon. Lady raised a point about discharge to assess and how it did not work for someone with a catastrophic injury. Again, we should pick that up in a conversation outside the Chamber. In general, the purpose of discharge to assess is a good one: to avoid people having long and unnecessary stays in hospital, where we know that frail and elderly people, in particular, are likely to decondition and live less independently as a result. She knows that well from the work that she does on social care. Once somebody has been discharged home, they are often able to live with more independence and regain mobility in a way that was not clear when they were assessed in hospital. Sometimes assessment in hospital will lead to delays and a longer stay in hospital, and to what is called over-prescription, with somebody ending up living longer in a care home when they might have continued at home. In general, discharge to assess is a good thing but, as I say, I am happy to look into the specific question of whether there might be circumstances, such as when somebody has had a very serious injury, when the process works differently. I will take that away.

The hon. Lady made a point about the involvement of patients in decisions about their care. It is fundamental that patients should be involved in decisions about their care, as should families and carers. In many circumstances, the patient and those around them will be the experts on what they will need. They need to be involved in the ramifications of whatever decisions are made. That should take place, but let us investigate further outside the Chamber whether that is working as it should be, together with the points she made about transparency and trying to ensure that people are involved when continuing healthcare is being assessed and considered.

I receive a significant amount of correspondence about continuing healthcare. The NHS has a challenging job to ensure that the decisions go the right way. I know the process can be long and hard for those involved in it. I want to ensure it works as well as it possibly can, so that those who should be eligible receive such care. I understand in Tom’s case that, after the appeal, the decision was made that he should be receiving continuing healthcare. How sad that that came after his death and after all the suffering that he and those close to him must have gone through.

I thank the hon. Lady for bringing Tom and his family’s situation to my attention. I commend her for her powerful speech and how clearly she put across the concerns. I look forward to speaking about this further outside the Chamber.

[Mr Deputy Speaker (Mr Nigel Evans)]

I pass on the deepest condolences of everybody here at the House of Commons to Tom’s family, friends and all who mourn his passing. It was a very moving speech.

Question put and agreed to.

Budget Resolutions

Debate between Nigel Evans and Helen Whately

Monday 1st November 2021 Commons Chamber

[Helen Whately]

I would like to sum up. In this Budget and spending review, we are seizing the moment to end historical disparities in education, health and employment opportunities, so that in the years ahead, more people throughout this United Kingdom will have the opportunity to live healthier, happier lives, and to fulfil their hopes, dreams and ambitions, wherever they live in the country.

[Mr Deputy Speaker (Mr Nigel Evans)]

Before the Whip moves the motion to adjourn the debate, may I say that there were 65 contributions from Back Benchers today? That has to be some sort of record for a Budget resolutions debate. I congratulate each and every one of you on your contribution.

Ordered, That the debate be now adjourned.—(Mrs Wheeler.)

Debate to be resumed tomorrow.

National Health Service

Debate between Nigel Evans and Helen Whately

Tuesday 13th July 2021 Commons Chamber

[Mr Deputy Speaker (Mr Nigel Evans)]

Thank you for that point of order, Sir Christopher. The Minister is on her feet and she looks as if she may respond to that point of order herself, as it is not a point for the Chair.

[Helen Whately]

Thank you very much, Mr Deputy Speaker. I was indeed intending to come to that point. I was commencing my speech by giving some further context, but I can respond to the specific point made by my hon. Friend. The impact assessment is being worked on. I will be clear with hon. Members. One of the challenges is that there is significant uncertainty about the level of behavioural change we may see in the weeks ahead from this and other measures, for instance the requirement for vaccination to travel to some countries, which we anticipate will lead to further vaccination uptake.

--- Later in debate ---

[Mr Deputy Speaker (Mr Nigel Evans)]

That is not a point of order for me, but it could have been an intervention upon the Minister, so let us allow the Minister to give the full response to the points that have been made and perhaps she can include that one from William Wragg.

[Helen Whately]

As I said, the impact assessment is being worked on. That is the current situation. I was explaining one of the challenges in coming to an impact assessment that we can share with colleagues to inform them accurately. I really hear that hon. Members want to have the full set of information for this debate. We face a dilemma: the clock is ticking and each day we are moving closer to winter. I am going to come on to it in the detail of my speech, but one important feature of this proposed legislation is that it gives staff a grace period in which to get vaccinated. The longer we take on this, the more risk there is to having that grace period.

--- Later in debate ---

[Mr Deputy Speaker (Mr Nigel Evans)]

Again, this is not a matter for the Chair, but it is certainly a point for the Minister to address. I think it would be helpful if the Minister could directly address that particular issue, which many Members are now raising.

[Helen Whately]

Thank you, Mr Deputy Speaker. There is not a great deal more that I can say on that point. As I have said, the impact assessment is being worked on and we will share it with colleagues as soon as we can. That is all I can say on that particular point.

[Sir Christopher Chope]

Further to that point of order, Mr Deputy Speaker. Yesterday, I asked the House of Commons Library to inquire of the Department where this impact assessment was, and the Department informed the Library that it was about to present the impact assessment. It did not say that the assessment was still under preparation. The implication was that it was ready to be given to the House and it was just a matter of time—they said they would do it as soon as possible.

[Mr Deputy Speaker]

Again, I can only say what I have heard during the debate and apparently the impact assessment is simply not available. This is clearly not the best situation. We can see exactly what it is, but it is what it is.

[Helen Whately]

Thank you, Mr Deputy Speaker.

The Scientific Advisory Group for Emergencies recommends that 80% of staff and 90% of residents should be vaccinated in any care home, at a minimum, to provide protection against outbreaks of covid. While the majority of care home workers have now been vaccinated, our most recent data has told us that only 65% of older-age care homes in England were meeting that safe minimum level, and the figure fell to 44% in London. That is why the instrument is being put forward today. It means that, by November, subject to parliamentary approval and a subsequent 16-week grace period, anyone entering a Care Quality Commission-registered care home in England must be vaccinated unless an exemption applies. That will apply to all workers employed by the care home, those employed by an agency and volunteers in the care home. Those entering care homes to undertake other work, for example, healthcare workers, tradespeople, hairdressers and CQC inspectors, will all have to follow the regulations.

The introduction of this policy has not been taken lightly. We have consulted extensively, including with a wide range of valued stakeholders, and used their feedback to inform this legislation. We recognise that some people feel that workers should have freedom of choice about vaccination, while others do it as a duty of care to protect the people most at risk. I know from speaking directly to people who receive care and to those who have relatives living in care homes that, although they might not be sure about requiring all care workers to be vaccinated, they are sure that they, individually, want to be cared for by someone who has been fully vaccinated. Many people have little choice about who cares for them.

Dementia Action Week

Debate between Nigel Evans and Helen Whately

Thursday 27th May 2021 Commons Chamber

[The Minister for Care (Helen Whately)]

I thank all Members who have spoken in the debate, and spoken so powerfully, time and again drawing on their personal experience of dementia in their family. That is a sign not only of the prevalence of dementia, but, as my hon. Friend the Member for Gloucester (Richard Graham) pointed out, of how much the stigma of dementia is being overcome.

My hon. Friend the Member for Scunthorpe (Holly Mumby-Croft) spoke about her family experience, but also about the importance of listening to family and the challenges of navigating the system and the administration involved for a family coming to terms with a diagnosis, who have to go through so many processes.

My hon. Friend the Member for Vale of Clwyd (Dr Davies) spoke about the importance of diagnosis with respect to not only the support that people need, but providing a cohort for trials and for research. He drew on his clinical experience, as well as his personal experience, and rightly mentioned the importance of the prevention of dementia and the role of diet and exercise in that.

My hon. Friend the Member for West Aberdeenshire and Kincardine (Andrew Bowie) spoke about how dementia affects the whole family. Very movingly, he spoke of how it affected him when his grandmother lost her power to speak, and of how he used to pray for her to return to being the person she once was.

My hon. Friend the Member for Stockton South (Matt Vickers) spoke about how many of those who care for someone with dementia may be frail themselves or may be holding down a job. He also spoke about Teesside Dementia Link Services and the huge difference that makes for those with dementia and their carers.

My hon. Friend the Member for Redcar (Jacob Young) spoke about his grandads’ very different experiences with dementia, and about the importance of treating those who suffer with dementia with the dignity that they deserve.

My hon. Friend the Member for Keighley (Robbie Moore) spoke about Dementia Friendly Keighley, which so effectively brings people together and provides support for patients with dementia and for carers. He particularly mentioned Barbara Wood, who he said was symbolic of the efforts of the group.

My hon. Friend the Member for Peterborough (Paul Bristow) spoke about how his grandma suffered from Alzheimer’s and referred to his experience as a result of his father running a care home. He spoke about our opportunity to take the same attitude to curing dementia as to the covid vaccination. He is absolutely right: this is a moment in time. We can look at how we have pulled together as a country and how the public and private sectors, scientists, healthcare specialists and others have come together to develop a vaccination for covid; it was forecast at the outset that that might take five or six years, yet here we are with so many millions of people already vaccinated. He also spoke about the antipsychotic medication of those with dementia during the pandemic. As he said—he has contacted me about this—we are working with the NHS to keep a very close eye on the situation.

My hon. Friend the Member for Southend West (Sir David Amess) talked about the importance of reform, including the reform of funding so that people do not have to sell their homes to pay for care. As I have said, we are absolutely determined to bring forward the reforms of social care that we have committed to bringing forward this year.

I want to touch on some of the comments by the shadow Minister, the hon. Member for Leicester West (Liz Kendall). She spoke very movingly in her winding-up speech and made important points about social care reform. She said that it is not just about reform for those who are receiving care right now—our mums and dads, for instance, or our grans and grandads. Many of us will also need care, and so will our children and grandchildren as people live longer. We need a system for ourselves and all those we love that we can be confident provides the care that we want and need.

In her opening speech, when the hon. Lady spoke about the response to the pandemic, she clearly did not hold back in what she said, which may be a sign that she shares my sorrow about the many lives lost to covid. She knows how hard this Government have worked to protect and support people who receive social care, and she knows how hard it has been for care homes in England, but also in Wales, where there is a Labour Government, in Scotland under the SNP Administration, and in many countries around the world.

In a pandemic it is impossible to get everything right, but we have provided unprecedented support to social care and care homes over the past year. Once again, I thank all those who have been involved, including the Department of Health and Social Care team, Public Health England, Skills for Care, the Association of Directors of Adult Social Services, the Local Government Association, local authorities, organisations that we have worked with, such as the National Care Forum, the National Care Association, the United Kingdom Homecare Association, Care UK, Age UK and Carers UK—I could go on, because there have been many of them. I also thank the care providers, the care users and the care workers themselves—the care workforce, who have been on the frontline and have done so much to look after those they care for, through such difficult times.

This is a moment in time, not only for social care reform but for dementia. Yes, we must restore the diagnosis rates and go further. We must make sure that the support is there for individuals with dementia and their carers. We must do more on prevention, because it is estimated that a third of dementia cases are preventable. The Government must, and will, follow through on our commitment to research effective treatments for dementia and find—sooner rather than later—a cure.

Question put and agreed to.

Resolved,

That this House has considered Dementia Action Week.

[Mr Deputy Speaker (Mr Nigel Evans)]

I will suspend the House for a brief moment for the sanitisation of both Dispatch Box covers and the safe exit and arrival of the main players.

Human Tissue

Debate between Nigel Evans and Helen Whately

Tuesday 19th May 2020 Commons Chamber

[Helen Whately]

May I welcome the hon. Member for Nottingham North (Alex Norris) to his place on the Front Bench and say how very good it is to see him there? I thank him for his kind words at the beginning of his speech and for his constructive tone in this debate. I look forward to that in our future conversations. I also welcome all the helpful and constructive comments we have heard from those who have been able to contribute to the debate today remotely and the work of all of those who have been involved in getting this legislation on to the statute book.

As I said in opening the debate, thousands of people up and down the country are in desperate need of a transplant. While covid-19 has completely stopped transplant services in some countries, we have been able to continue with very urgent transplants, and that is testament to the great work of NHS Blood and Transplant and NHS England. We now want to go further, and we must increase the availability of organs for transplant, which this important legislation will allow us to do, especially at a time when covid-19 has taught us so much about how fragile life is.

I should say that patient safety and the involvement of the family in discussions about organ donation will remain absolutely a paramount consideration, and we will keep raising awareness of the importance of organ donation. The communication campaign from NHS Blood and Transplant has seen awareness as high as 62% of the population at the height of the campaign, and that must go further. We must continue tackling some of the myths about organ donation.

Coming to some specific questions and points made by other Members, the hon. Member for Nottingham North asked about the recovery plan following covid-19 and the unavoidable reduction in transplants that has happened during the pandemic. We are determined to see transplant units become fully operational as soon as possible. Most transplant units are working on their plans to reopen or to increase services if they have stayed open, and I expect to see a rapid ramping up of their activity.

The hon. Gentleman asked about specialist nurses, and I can confirm that specialist nurses have indeed been recruited and have training ongoing in, for instance, the principles of this legislation and in practical sessions on the conversations and approaches to families. I am happy to come back to him separately with some further detail about that work.

The hon. Gentleman and the hon. Members for Strangford (Jim Shannon) and for Coventry North West (Taiwo Owatemi) made very important points about BAME communities. It is clearly of great concern that there is reduced access to organs for transplant, with a shortage particularly of donor organs for some people in BAME communities. We really want this law to address some of those very concerning health inequalities. Specifically, black and Asian people wait on average about 11 months and six months longer, respectively, for an organ match than the rest of the population. That is absolutely something that this legislation should and must address.

The hon. Member for Nottingham North asked about communications to BAME communities, because that is crucial for the success of this change. I should say to him that there has been specific funding to BAME and faith groups to raise awareness within their communities, but I agree that more must be done to make sure that this is successful.

The hon. Member for Coventry North West asked about screening for covid-19. There are two sides to this. First, a registry has been set up to monitor covid cases among those waiting for a transplant, and, secondly, I have been assured that the organs of those who have covid would not be donated and used for transplant.

I was also asked about the resources to fund this, and I can say that of course we will make sure that the NHS has the resources it needs to be able to carry out these crucial transplants.

It is important that this legislation is approved to provide legal certainty that deemed consent will apply only to the routine transplants that so many people in this country need. I want to thank everyone who has spoken and contributed to the work on these regulations. The regulations are an integral part of making the new system of consent work, and I would urge all my fellow parliamentarians to approve them. We owe it to everyone waiting for a transplant to make sure that Max and Keira’s law comes into force and makes a difference to all those who are waiting for a transplant.

[Mr Deputy Speaker (Mr Nigel Evans)]

I announced to the House earlier this afternoon my provisional determination that a remote Division would not take place on the question now before the House. This is also my final determination.

Question put and agreed to.

Resolved,

That the draft Human Tissue (Permitted Material: Exceptions) (England) Regulations 2020, which were laid before this House on 25 February, be approved.