Terminally Ill Adults (End of Life) Bill

Oliver Dowden Excerpts

2nd reading
Friday 29th November 2024 Commons Chamber

[Kim Leadbeater]

Absolutely not. I respectfully disagree with the right hon. Gentleman. In countries where a Bill of this nature has been implemented, the safeguards have been in place and the boundaries have never changed. I will come on to talk about that.

[Sir Oliver Dowden (Hertsmere) (Con)]

rose—

[Kim Leadbeater]

I will take one more intervention and then I must make some progress.

[Sir Oliver Dowden]

I thank the hon. Lady for giving way. I have a great deal of sympathy for the arguments she is making. However, we have seen, time and again, excessive judicial activism taking the words in this House and expanding their meaning into places we had not foreseen. What reassurances can she give that the words in her Bill will be respected by the judiciary and that we will not find ourselves in a decade’s time in a totally different place that this House did not intend?

[Kim Leadbeater]

I thank the right hon. Gentleman for his intervention. The courts have repeatedly put this issue back to Parliament. This is not their domain. This is the legislation. There are strict criteria.

Coming back to palliative care, in situations where pain simply cannot be managed, the result is deaths that are so horrific that the person themselves can spend hours, and in some cases days, in unimaginable pain as they die. I want to bring the debate back to the issue that we are trying to solve. For their loved ones, no matter how many joyful and happy memories they have, they also have the trauma that comes from watching someone you love die in unbearable agony and fear. That memory stays with them forever.

Rebecca’s mum Fiona developed metastatic brain cancer at the age of 69. She had very good palliative care, but her pain could not be managed, and she died begging and screaming for assistance to end her suffering. Her family and the medical team treating her cried beside her bedside as it took her 10 days to die.

Lucy’s husband Tom was 47, a music teacher with a young son. He had bile duct cancer which obstructed his bowel, resulting in an agonising death. Tom vomited faecal matter for five hours before he ultimately inhaled the faeces and died. He was vomiting so violently that he could not be sedated and was conscious throughout. Lucy pleaded with the doctors to help. The doctor treating him said there was nothing he could do. His family say that the look of horror on his face as he died will never leave them. Lucy now has post-traumatic stress disorder, which is quite common for families who lose loved ones in such harrowing circumstances.

Oral Answers to Questions

Oliver Dowden Excerpts

Tuesday 31st October 2017 Commons Chamber

[Dr Lee]

The hon. Gentleman is fully aware that the part of the world that he used to represent as a Mayor is quite ahead in dealing with individuals more holistically. Staffing is an issue. We have brought forward a youth custody officer role, which will start in 2018, and we are bringing forward another 80 people for a course to improve the type of care that those individuals can offer. We are under no illusions about the challenges. The guidelines on how we are procuring secure schools and their staffing arrangements will be announced in the new year.

[Oliver Dowden (Hertsmere) (Con)]

13. What steps the Government is taking to ensure successful prosecutions for child abuse.

[The Parliamentary Under-Secretary of State for Justice (Dr Phillip Lee)]

We are taking action across the Government to bring about a step change in the response to the sexual abuse and exploitation of children, including the commencement of the roll-out of recorded pre-trial cross-examination for vulnerable witnesses in Crown courts in January 2017. Further roll-out for vulnerable witnesses, which includes child victims of sexual abuse, will continue in the autumn.

[Oliver Dowden]

It takes tremendous courage for children to come forward in such cases. The process of giving evidence is often extremely harrowing. They deserve justice, and when that does not happen they are left deeply disillusioned with the system. It is something I have seen in my own constituency. What further steps can the Government take to ensure that justice is done? In particular, will the Minister look at the operation of the criminal injuries compensation scheme to ensure that child abuse victims are treated fairly?

[Dr Lee]

It is an important point that the nature of grooming can make signs of abuse particularly challenging to detect. That is something that CICA—the Criminal Injuries Compensation Authority—has to address. That is why it has consulted with experts and charities to produce recently published new guidance to ensure every victim gets the compensation to which they are entitled.

Attacks on NHS Staff

Oliver Dowden Excerpts

Monday 27th February 2017 Westminster Hall

[Oliver Dowden (Hertsmere) (Con)]

I beg to move,

That this House has considered e-petition 176138 relating to attacks on NHS medical staff.

It is a pleasure to make these introductory remarks under your chairmanship, Mr Gray. The petition highlights the rising problem of attacks on NHS staff, an issue with which I am very familiar from my constituency work. Indeed, local GPs recently raised it with me in my surgery in Radlett. I pay tribute to listeners of London’s LBC radio, who backed this petition as part of the Guard our Emergency Medical Services—GEMS—campaign. Their support for the petition helped to push the number of signatures well over 100,000, which the Petitions Committee usually takes as a benchmark for triggering a debate in this place. I also thank the Royal College of Nursing and the many other representative organisations that have contacted me to highlight the scale of the problem. It is clear that the petition has struck a chord with the public and hon. Members.

The raw facts speak for themselves: there were more than 70,000 recorded assaults on NHS staff in England in 2016—an increase from nearly 68,000 in 2015 and 60,000 in 2004. In the NHS trust serving my constituency, there were more than 1,000 recorded assaults last year. A recent RCN members’ survey found that 56% of nurses had experienced physical or verbal abuse from patients, and a further 63% had experienced abuse from relatives of patients or members of the public.

Those statistics tell only one side of the story. Since I agreed to lead this debate on behalf of the Petitions Committee, I have been inundated with examples of the scale of the problem. I will cite just a few, which were compiled by 38 Degrees. An NHS staff nurse said that in her

“20 year nursing career I have been spat at, punched, kicked, verbally abused…and even had a cardiac monitor thrown at my head!”

Another said that she works

“in an A&E department as a staff nurse. On a daily basis I see some sort of aggression whether this is physical or verbal towards staff. I can’t recall a day that has gone by where we’ve not had to have security or the Police in the department.”

Perhaps more worrying is evidence given to the Petitions Committee by the Royal College of Nursing, which suggests that some female nurses fear that they are seen as “fair game” for sexual assault. I am sure hon. Members find that appalling.

This problem does not just affect NHS staff working in hospitals and GP surgeries. Concerns have been raised about the safety of lone NHS workers—for example, nurses visiting care homes. Such violence against NHS workers is clearly completely unacceptable, and all Members of the House agree that we must not stand for it. This debate is an opportunity to highlight the problem and send a clear signal from this House that it cannot be tolerated. It is also an opportunity to consider measures to tackle it.

The petition calls for higher legal provision and protection to be extended to NHS staff, making it a specific offence to assault them. As the petition makes clear, that protection is already afforded to police officers under section 89 of the Police Act 1996, and my research indicates that it is also a specific offence to assault prison and immigration officers. It is also an offence to assault doctors, nurses and midwives in Scotland. I raised that point with the Prime Minister at Prime Minister’s questions, and I know from both the response I received subsequently from her and the Government’s response to the petition that they take this problem seriously.

I understand that the current position is that, first, to ensure that prosecutions are brought forward once a charge has been made, the code for Crown prosecutors makes it clear that a prosecution is more likely if the offence has been committed against someone who was serving the public at the time, which includes NHS workers. Secondly, at the sentencing stage, the fact that an offence was committed against a person working in the public sector is an aggravating factor, which means that it is considered as adding to the seriousness of the offence, thereby meriting a longer sentence within the maximum penalty available. In addition, current sentencing practice indicates that custody is used as a starting point for assaults on public servants.

[Mr George Howarth (Knowsley) (Lab)]

Although what the hon. Gentleman said about aggravating factors, which are set by the Sentencing Council, is important, the argument for having a specific offence rests on the fact that medical staff often deal with people in stressful and sensitive situations, so they deserve a better level of protection equal to that afforded to police officers.

[Oliver Dowden]

The right hon. Gentleman makes an apposite point, which I was just about to come on to.

I welcome the progress that has been made as a result of the petition. I understand that the Government have committed to updating the protocol on tackling violence in the health system, which will involve the police and the Crown Prosecution Service, and I would be grateful if the Minister could update us on that in his concluding remarks. Like the right hon. Gentleman, I urge the Government to keep an open mind about creating a new specific offence.

[Richard Drax (South Dorset) (Con)]

My hon. Friend is making an excellent speech on a subject that is close to many of our hearts. I pay tribute to all those who work in the NHS and do a wonderful job. I wish to raise an issue that my police and crime commissioner raised with me, which affects all those who work in the emergency services—that of spit guards. The PCC has written to the Home Office to ask it to research this issue further and to hold a public consultation. What is my hon. Friend’s view on how we can stop people spitting on people, which is just as much of an assault as thumping someone? Perhaps the Minister will inform us how far down the road we are on that issue.

[Oliver Dowden]

My hon. Friend is absolutely right, and hopefully this debate will provide the opportunity not just to discuss a specific new criminal offence but to look at preventive measures. Certainly, spitting at NHS staff is completely unacceptable, and any measures we can take to prevent it would be most welcome. Like him, I would be grateful to hear the Minister’s reflections on that point.

Returning to the argument about why we need a specific offence, I understand the Government’s point that existing measures already prioritise prosecuting and sentencing assaults on NHS workers. All assaults are unacceptable, but the fact that we have created specific offences for police, immigration and prison officers, but not one for NHS workers, might amount to a discrepancy. It is important that we send the strongest possible signal from this place that such assaults are unacceptable, and creating a specific offence is one way to do that.

It is important to stress that a new law is not a panacea. This debate provides an opportunity for a wider examination of safety issues surrounding NHS workers. I have a number of issues to raise, and I would be grateful if the Minister addressed them in his remarks. Concerns have been that only about 10% of physical assaults result in criminal sanctions. I would be grateful if the Minister could confirm whether the Government’s promised review of the protocol will look at how that low level of prosecution can be addressed. In addition, the consultation that the Petitions Committee held on this debate suggests that there is scope for more effectively training security staff at NHS facilities in how to deal with violent behaviour to ensure that difficult situations do not escalate.

Further work can be done on preventive measures. My hon. Friend the Member for South Dorset (Richard Drax) mentioned spit guards. Other possibilities mentioned to me include the provision of lone-worker alarms for NHS staff visiting care homes on their own and better designed environments that make it harder for violent offences to be committed. There is, however, concern about the future of NHS Protect, so will the Minister provide some clarity on that?

A wider question concerns changing attitudes towards NHS staff. The Petitions Committee received evidence that some people have an entitlement attitude—“We’ve paid our taxes”—which is sometimes used to justify aggressive behaviour towards NHS staff. That needs to be stamped out. I rarely cite Wales as a good example of NHS practice, but it has had a campaign on zero tolerance of violence against NHS staff, which I believe has worked well. Perhaps that is something else the Minister will consider.

I am conscious that other Members wish to speak in the debate, so I will conclude. I hope that the NHS staff listening to the debate will be reassured by the seriousness with which Parliament treats the issue of violence against NHS workers. I hope that the debate will provide an opportunity to consider what further measures we may take to protect nurses, doctors, paramedics and all other NHS staff, to whom we all owe a tremendous debt of gratitude.

--- Later in debate ---

[Oliver Dowden]

Thank you again for your chairmanship, Mr Gray. I thank all hon. Members for their contributions. I hope that everyone agrees that this has been a useful debate not only in drawing out the powerful experiences of NHS workers suffering assaults, but in getting greater clarity about the extent to which a new offence is needed and what that offence might look like.

I thank the Minister for his constructive engagement. I hope that this is the beginning of a process. A lot has been said about zero tolerance. Certainly the experience with drink-driving was that we managed to move from a situation in which drink-driving was commonplace to one in which it was completely socially unacceptable. We need to go along a similar path with assaults on NHS workers.

Question put and agreed to.

Resolved,

That this House has considered e-petition 176138 relating to attacks on NHS medical staff.