Coronavirus Response

Patricia Gibson Excerpts

Monday 20th July 2020 Commons Chamber

[Matt Hancock]

Yes, that is exactly the plan. They got that data at postcode level last week, and they will now get even more detail, including the identities of people who have tested positive, so that they can support them and work with NHS test and trace yet more effectively. Kirklees has been proactive in how it has managed the outbreaks it has had so far. It had outbreaks about a month ago, which it got right on top of, and it is working very hard in the current circumstances.

[Patricia Gibson (North Ayrshire and Arran) (SNP) [V]]

Yesterday saw the single largest daily recorded number of global covid cases, as well as a protest against masks on the streets of London and an illegal rave attracting thousands of people outside Bath. How can the Secretary of State persuade people to get behind his Government’s public safety message?

[Matt Hancock]

I am glad to say that the vast majority of people respond positively to the public health messages that we have been putting out throughout, and it is a very important part of the policy.

Independent Medicines and Medical Devices Safety Review

Patricia Gibson Excerpts

Thursday 9th July 2020 Commons Chamber

[Ms Dorries]

My hon. Friend raises the important issue of informed consent, which has come very much to the fore recently, including how detailed consent needs to be and how much information people need to have. Of course we are working with those women and ensuring that they have every detail and every bit of information that they require before mesh is removed so that they know exactly what operation they are undergoing. That needs to be a template for moving forward. Informed consent needs to be what we move forward with in much more detail, so patients are fully aware of the risks and benefits of any surgical procedure they are undergoing.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

One of the most disturbing aspects of Baroness Cumberlege’s report is the way that women have been dismissed when they report concerns and debilitating pain. This is a fundamental point in this entire scandal: as multiple studies have shown, there is an imbalance between the experiences of men and women in many areas of medicine, suggesting that a gender health gap does indeed exist, and often shows up in the misdiagnosis of women’s symptoms, while at other times it appears that their health concerns are just not taken as seriously. I have heard what the Minister said in response to earlier questions on this issue, but undoubtedly this is a systemic problem. Does she have any plans to review male bias across the NHS involving devolved Governments?

[Ms Dorries]

The hon. Lady is absolutely right in everything she said, and I completely agree with her, 100%. My team of officials and I, from the very first day that I arrived in the Department, have been looking at a women’s agenda and at the way that in so many areas of healthcare there does appear to be an unintentional bias. I am not saying that it is intentional and I would not particularly use the word “misogyny”, but there is an unintentional bias. It is proven by the amount of time it takes for women to have their voices heard and for their complaints to be taken seriously and yes, addressing that is absolutely a priority. The problems that women were subjected to and the prolonged pain they experienced simply because their voices were not being heard is something that we will have to address in our response. That bias against women must surely be obvious from the amount of inquiries that we are having about women-only issues, and I hope that highlighting that, bringing it here and not being afraid to ask for inquiries where we see that bias taking place, is like shining sunlight on it—to quote someone long before my time. It is only by opening up these issues, allowing a spotlight to be shone on them and not being afraid of what we find that we can go anywhere towards addressing this. We do it by establishing a blame-free culture, a bit like the airlines industry has in the HSSIB, where we look at incidents that have happened, do not blame anyone, and make sure clinicians, nurses and healthcare workers can reveal what has happened in an incident. By doing so, we can put the learnings in place to make sure that it does not happen again.

Covid-19 Update

Patricia Gibson Excerpts

Monday 29th June 2020 Commons Chamber

[Matt Hancock]

Yes, I can absolutely confirm the point about the lessons being learned and then promulgated in other places around the country, not least because we want to empower local councils to be able to look out for a flare-up themselves and then to escalate that straightforwardly through the process I outlined in my statement. We will shortly be publishing more details on exactly how that process works. I absolutely agree with him and will commit to this House that if further action is needed, whether in Leicester or around the country, we are not enthusiastic about taking that action, but we absolutely will if it is necessary.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

Future lockdowns, where necessary, must be decisive and prompt, and they of course depend on public compliance, but in practical terms, can the Secretary of State give us a bit more detail about how they will work? For example, the furlough scheme pays 80% of wages during lockdown, and it is due to be rolled back from 1 August. Can he confirm that in local lockdowns after 1 August, wherever they are required, 80% of furlough support will be available to assist with lockdown compliance, which is so important for public health?

[Matt Hancock]

Of course, as we move from a national lockdown towards local lockdowns, we are going to have to take more specific action. For the time being and for Leicester, the existing furlough scheme of course exists.

Health and Social Care Workers: Recognition and Reward

Patricia Gibson Excerpts

Thursday 25th June 2020 Commons Chamber

[Catherine McKinnell]

My hon. Friend anticipates my next comment, because that idea is receiving a mixed reception. One NHS worker wrote to me:

“I’ve heard whisperings of NHS staff getting medals after the pandemic. Please don’t let this happen! It’s utterly ridiculous; when we are working in understaffed and under resourced settings for money to be spent on medals is outrageous! No one wants that. We’d rather the money go towards improving staff car parking or access to hot food if anything!”

Another constituent wrote to me to say:

“pay rise for the NHS and care workers. They do not need medals.”

While medals and honours have a place in recognising exceptional achievements, there is clearly also a need for true recognition of their bravery and resilience during this crisis, and also for the amazing job they do every single day.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

I want to begin by stating an interest: my sister Kathleen and her daughter Chloe both work in the care system. Does the hon. Lady agree that what is missing here is political will, in talking about decent pay that tries to measure the value of the work they do? As of 1 April, the Scottish Government gave an immediate 3.3% pay rise to social care workers and are in the process of establishing a top-up fund for social care workers who contract covid-19 in the course of their duties. Does the hon. Lady agree that that kind of action should be replicated across the UK?

[Catherine McKinnell]

We will see if there is the political will when the Government respond to this debate today, and afterwards as well.

One of the petitions we are considering today, with over 162,000 signatures, calls for an increase in pay for NHS healthcare workers. They are doing tough work in very challenging circumstances, putting their lives on the line, and for ever-squeezed pay. There have been calls for staff to get paid properly for all the hours they work, especially overtime, which really is not too much to ask.

The Royal College of Nursing has taken issue with recent claims by the Secretary of State for Health and Social Care that nursing staff have received a “significant pay rise”. The college’s research shows average earnings for NHS staff have not kept pace with the cost of living since 2010. Ahead of the next pay round for 2021-22 it is calling for an

“honest dialogue…in valuing the nursing workforce”.

We know we have a shortage, and paying health workers properly is key to having the workforce we need. It would be a grave error by the Government if, following the crisis and the recession that we are already heading into, they look to balance the books on the backs of public sector staff in the way we saw after the banking crisis in 2010—the very same public sector workers we have been clapping for in gratitude for saving so many lives. Neither must we see a repeat of the junior doctors dispute, where staff were treated appallingly and morale was devastated as changes to pay and conditions were forced through.

While he and I would certainly disagree on the detail, I echo the comments made by the former Chancellor the right hon. Member for Bromsgrove (Sajid Javid), calling on the current Chancellor to focus on growth, not austerity. We cannot cut our way out of this recession, and certainly not with cuts aimed at the very people who are getting us through this crisis.

Many medical students have also stepped up to support their future colleagues in fighting the virus. There are parliamentary petitions calling for reimbursing fees and reducing student loans. The Petitions Committee is conducting an inquiry into the wider impact of this crisis on students, as there has been unparalleled disruption to higher education.

Before this crisis, student finance reforms also impacted on the healthcare workforce. The decision to scrap NHS bursaries in England and replace them with loans led to applications falling by a quarter, and there are almost 40,000 unfilled nursing posts. While that error has been partially corrected by the restoration of maintenance grants, this will not benefit current students.

One petitioner says that nurses

“will surely work tirelessly to do their best to keep the rest of us safe while at the same time they continue to be charged interest on these loans for a cost which they should not have been required to bear in the first place.”

Another, calling for the current intake to receive grants, says:

“Most student midwives and nurses in those intakes will leave university with at least £60,000 debt, despite having committed to a career in a valuable public service at a time when the NHS is in desperate need of more of them.”

Addressing student finance for healthcare students would be a way to both recognise the efforts of the current intake and help attract more to the profession, but unfortunately the insensitive comments of the Minister for Care recently are a bad start to this, so I urge the Government to do everything they can to rebuild trust.

But the most devasting impact of all has been in social care. Our care homes and their elderly and vulnerable residents have painfully borne the brunt of this crisis. More than 16,000 people have died from covid-19 in care homes, almost a third of all fatalities. Far from the Government wrapping a protective ring around care homes, in the early days of this crisis they were left exposed, without adequate PPE or testing for staff despite their desperate pleas. The human cost of this failure is harrowing.

The crisis has well and truly exposed how neglected our care system has become. Too many staff are low paid and on insecure contracts; too many have had to make choices between risking people’s lives, including their own, or going without pay. Many carers do not receive even the national minimum wage because they are not paid for travel or sleep time.

Campaigners, including the trade union Unison, have been calling for care workers to earn the real living wage of at least £10 an hour outside of London. Working conditions and employment rights vary immensely between care providers and we need to see care workers properly recognised and rewarded for the vital work they do.

Testing of NHS and Social Care Staff

Patricia Gibson Excerpts

Wednesday 24th June 2020 Commons Chamber

[Jonathan Ashworth]

We are calling for weekly routine testing, as have many organisations and the Chair of the Select Committee on Health and Social Care. He penned an excellent article in The Daily Telegraph today, and I hope the hon. Gentleman has had time to study it, because it is superb. May I also take this moment to pay tribute to the hon. Gentleman, because I know he has returned to the frontline? I am sure all of us, from across the House, are grateful for everything he is doing on the frontline.

The other point I wish to make on this growing burden of unmet clinical need is that there is a social gradient in this, as always; there is a higher mortality rate among those who are poorer and more deprived. Through all these different conditions, the poorer someone is, the more likely they are to become ill quicker and die sooner. So we need urgent action from the Government to tackle this, and we believe that regular testing of NHS staff is a key part of that.

We also need a broader plan to tackle the growing burden of sickness and unmet need. Our NHS will need more resources. We have had years of financial starvation in the NHS. The Government’s funding plan of two years ago fell short of the annual 4% increase that experts said was needed before the pandemic, and the settlement of that long-term plan is surely inadequate post pandemic. We must remember that we entered this crisis after 17,000 bed cuts and years of budget cuts to capital settlements, which have left hospitals crumbling, reliant on out-of-date equipment and grappling with a £6.5 billion repair bill. NHS land and buildings have been sold off. Last year, more than 890 hectares of NHS land was put up for sale. So we will need large-scale investment in the real estate of the NHS to allow health services to reconfigure to treat covid and non-covid patients alike.

Ministers will say that the NHS will get what it needs, but the reality on the ground is very different. I am sure the Minister for Care will have studied today’s Health Service Journal ahead of the debate and will have seen trust chief executives complaining that the cash that they were promised has not been delivered. They need this cash now if they are to restructure any of their services ahead of the winter. I hope that she will update the House on when those chief executives are going to get the cash they were promised by her Department.

We will also need real investment in rehabilitation services for those suffering from covid. The more we know about this disease, the more we know that those coming out of hospital are probably doing so with significant long-term chronic conditions. They are going to need support, be it respiratory, neuromuscular or psychological. Community health services are going to see a huge peak in demand now that many have moved out of the community health sector.

Crucially, to reset services—this comes to the point that the hon. Member for Crewe and Nantwich put to us—we need to ensure that care can be delivered safely, which is why we believe that a mass-testing infrastructure for staff is now so important. We know that around a fifth of covid infections in hospitals are caught in hospital settings. Given the levels of significant asymptomatic and pre-symptomatic transmission, we need a proper targeted testing strategy as well. All healthcare workers should be tested regularly—weekly—because a study from Imperial suggested that that would reduce transmission in healthcare settings by up to a third.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

The hon. Gentleman is eloquently outlining the challenges faced by the NHS in the wake of covid-19. Does he join me in welcoming the movement by the Scottish Government to ensure that social care workers who contract covid-19 are given additional funds on top of statutory sick pay, which is completely inadequate, in order to make sure that they do not lose out for testing positively as a result of their job?

[Jonathan Ashworth]

The hon. Lady makes a very important point, which affects the debate more broadly: those who test positive or are asked to isolate need to be given the financial support to do it, and statutory sick pay in many circumstances will not be enough. There are millions of workers—2 million in this country—who do not qualify for statutory sick pay, and just saying that they can apply online for universal credit is not going to be enough.

We need more radical thinking from the Government. Other countries offer greater financial support to those who are asked to isolate. Other countries even offer hotel rooms to those who are asked to isolate if it is not appropriate for them to isolate at home because of the nature of their housing situation. The Government should be looking into those sorts of things, and I hope the Minister can respond to that.

The point I was making is that regular testing of staff, whether asymptomatic or not, is so important not only for the safety of those staff and patients, but for building confidence in the NHS more generally. The study from Imperial suggested that it would reduce transmission of covid in healthcare settings by up to a third. We believe that this is a constructive suggestion that we are putting to the Government, which they should take on board and explore. It is disappointing that they are seeking to amend the motion to completely strip that out. They are not even prepared to take it away and look into it. They just want to pass a motion congratulating themselves on their handling of the pandemic.

A testing strategy for staff and patients, as we are proposing today, is a demand supported by many across the NHS as key to restarting that NHS work.

“A clear testing strategy is now more important than ever”—

says Chris Hopson from NHS Providers.

We

“need rapid testing available for all staff and patients, whether showing symptoms of COVID-19 or not”—

says Cancer Research UK.

“It’s absolutely essential to regain public confidence that we are able to test our staff regularly”—says Derek Alderson of the Royal College of Surgeons. And, of course—the right hon. Member for South West Surrey (Jeremy Hunt) will not be surprised that I am going to quote him in this debate—it is a position shared by the former Health Secretary, now the Chair of the Health and Social Care Committee, who in today’s Telegraph makes the case with far greater eloquence than I could ever muster:

“Until we minimise the risk of asymptomatic transmission by introducing weekly testing for all NHS and care staff, we are failing in a basic duty of care to the people most likely to die if they get the virus.”

Coronavirus

Patricia Gibson Excerpts

Wednesday 17th June 2020 Commons Chamber

[Matt Hancock]

My hon. Friend speaks movingly of the support that so many have given, and her three constituents deserve our praise for their work—along with hundreds of thousands, if not millions, of others—to support those who have been living alone. Whether the 2.2 million people who are shielding because they are clinically extremely vulnerable, or the over 8 million people who live on their own and therefore have had to stay on their own during lockdown, this has been a difficult time for many. I pay tribute to the community spirit and support for others that so many have demonstrated.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

The link between poverty and poor mental health is well understood. As the covid easing continues, we face the prospect of an economic depression the likes of which we have not seen since perhaps the 1930s, and ahead looms the potential for a post-covid mental health pandemic. What specific and additional resources is he prepared to commit to alleviate that risk?

[Matt Hancock]

Nobody wants to see the sort of economic consequences that we have already seen—even if there are more to come—but we have to take these measures in order to tackle this pandemic. We have put extra support into mental health, and more is to come. It is a really important part of the solution.

Alcohol Harm

Patricia Gibson Excerpts

Tuesday 17th March 2020 Westminster Hall

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

I am pleased to be participating in this debate. I begin by paying tribute to the hon. Member for Congleton (Fiona Bruce) for giving us a very thoughtful and comprehensive opening to the debate. I begin also by saying that people have mentioned the effect of being isolated at home because of the coronavirus and that it is worth bearing in mind, as we go through this crisis, that drinking alcohol lowers the body’s immunity.

We have heard a lot today about the damage of alcohol over-consumption. The cost to our families, our communities and ourselves is almost incalculable. It cannot be counted in pounds and pence, although very often we are forced to do that, for practical reasons. Alcohol abuse leads people to lose their homes, families and jobs. There is a cost in hospital admissions, perhaps on numerous occasions, and people may even end up encountering the criminal justice system. Victims of alcohol abuse become economically inactive. They often become absent parents. The damage to mental health and physical and emotional wellbeing is profound.

I remember standing in this Chamber a couple of years ago to speak on alcohol abuse. A number of us involved in that debate were willing to admit that we came from homes with an alcoholic parent. My father was by all accounts an alcoholic, although I never knew him, as he died when I was 15 months old—he was very much helped on his way by alcohol. The damage to my family was not insignificant. My husband’s father was also an alcoholic and died because of the demon drink. These stories are not unusual; in fact, they are far too common. Almost every person we meet has a family member or knows someone who is an alcoholic. That is very sad, but it is a fact of life. However, that does not mean that we cannot turn things around. It does not mean there are not measures that we can take and, in Scotland’s case, have already taken to combat this problem. There is no silver bullet, but much can be done to mitigate the harmful grip that alcohol has on our communities. In the round, a number of measures can be taken.

In Scotland, 686 hospital admissions and 22 deaths every week are due to alcohol. In 2018, the figure for alcohol-specific deaths was 1,136. In 2018-19, there were 35,685 alcohol-related hospital admissions in general acute hospitals. Worryingly, hospital admissions are still more than four times higher than the level seen in the 1980s. Clearly, in Scotland, we could not simply shrug our shoulders and tolerate that. We tried to turn the situation around. I am pleased that the SNP Government chose to use the powers at their disposal to tackle the level of alcohol harm suffered by our communities, at great cost to those communities, on every single measure.

The hon. Member for Congleton pointed out the need for England to have a revised or updated alcohol strategy, and she is correct to say so, as the current one is out of date. Indeed, the Scottish Government updated their own alcohol strategy in 2018.

I could stand here today and talk about the fact that the Scottish Government have invested almost £800 million to tackle alcohol harm and drug use since 2008 and will allocate a further £95 million next year to reduce the harms caused by alcohol and drugs. I could mention—indeed, I have already alluded to—the Scottish Government’s alcohol framework setting out 20 actions that build on existing measures to change Scotland’s relationship with alcohol. I could even mention the legislation introduced by the Scottish Government to ban irresponsible alcohol promotions, such as the multi-buy discounts in supermarkets.

[Jim Shannon]

Will the hon. Lady give way?

[Patricia Gibson]

I am worried about time, so I will press on, if that is okay.

That legislation was associated with a 2.6% reduction in consumption in the 12-month period following its introduction from October 2011. The hon. Member for Henley (John Howell) might be interested to know that in 2014 Scotland reduced the legal alcohol limit for drivers from 80 mg to 50 mg in every 100 ml of blood. That reduction has not been made in the rest of the UK, which, apart from Scotland, currently has the joint highest levels in Europe that are permitted for driving. I could mention a whole range of measures—

[Ian Paisley (in the Chair)]

The hon. Lady has another six minutes. She does not need to feel that she is rushed.

[Patricia Gibson]

Okay. I will give way briefly.

[Jim Shannon]

I compliment the hon. Lady and particularly the Scottish Parliament on what they are doing. The hon. Lady has outlined a blueprint for the whole of the United Kingdom of Great Britain and Northern Ireland. We should all take note of it and let it be our blueprint for Northern Ireland, Wales and England.

[Patricia Gibson]

I thank the hon. Gentleman for his comments. As I will go on to say, there is no room for complacency in any part of the United Kingdom. There are things that work that every part of the United Kingdom should implement, and the UK should continue to review them to see how the measures can be improved.

All the measures that have been taken, on their own merits and collectively, represent real action and commitment to dealing with the scourge of alcohol on our communities. Many of them were set out by my hon. Friend the Member for East Lothian (Kenny MacAskill), who has significant insight into the issue from his role as Cabinet Secretary for Justice in the Scottish Government. There has been broad agreement today that minimum unit pricing for alcohol is the single most significant action that can be taken to tackle alcohol harm, as we have seen in Scotland, but it is not a silver bullet. Nothing is, and nothing ever will be. As my hon. Friend the Member for East Lothian reminded us, it is part of a package of measures and must be seen in that context. I urge the Minister to emulate that measure in England in order to benefit the communities that many Members in this Chamber represent.

When it comes to the strongest drinks on the market, in England we can buy cider for 18p, lager for 23p, vodka for 36p and wine for 38p—I am talking about units, not bottles. Minimum unit pricing was introduced in 2018 in Scotland. Shamefully, the policy was delayed for several years as the alcohol industry dragged it through every court it could find to stop it or delay its implementation for as long as possible. Studies indicated that there would be around 121 fewer deaths a year as a result, and there would be a fall in hospital admissions of just over 2,000 a year by the end of year 20 of the policy.

It gives me no pleasure to say that the initiative sadly met more blocks during its passage through the Scottish Parliament, as opposition parties opposed it purely on the basis that nothing the SNP Government introduced could ever be supported. Although that is the usual response to any SNP policy in the Scottish Parliament, eventually the Tories abandoned their absurd opposition. Labour, however, simply could not bring itself to do so because it was an SNP initiative. The Labour party argued and argued against it and grew more ridiculous with every word. In the end, unable to support it even in the face of overwhelming evidence that it would be a key weapon in the battle against alcohol harm, Labour contented itself with abstaining on the issue. I know that many Labour MPs from other parts of the UK looked on at their Labour colleagues with bewilderment at what was going on—not for the first time, and probably not for the last. Willingness to put narrow party politics before public health is one of several reasons why the Labour party in Scotland is completely adrift. Some issues go far beyond party political lines.

The evaluation of the first year of alcohol minimum pricing has been very promising. As the first country in the world to introduce such a measure, we saw off-trade sales per adult in Scotland fall by 3.6% in the first year after implementation. In the same period in England, there was a rise of 3.2%. There was an 18.6% fall in off-trade cider sales per adult in Scotland in the year following minimum pricing, and an 8.2% rise in sales in England and Wales. There is still more to do, and there can be absolutely no complacency.

A 50p per unit price provides a proportionate response to tackle higher-risk alcohol use. We know there is a proven link between consumption and harm, and that minimum unit pricing is the most effective and efficient way to tackle the cheap, high-strength alcohol that causes so much harm. Going back to the comments made by my hon. Friend the Member for East Lothian, the World Health Organisation said that tobacco education was not, and could not be, as effective as regulation and Government action. We need to remember that when we seek to tackle alcohol harm.

People in Scotland still buy 9% more alcohol per head than those in England and Wales, but that gap is closing because of growing sales of alcohol in England and Wales last year. A 50p minimum unit price is no longer sufficient, because after it was brought in in 2012, the implementation of the policy was delayed by court action for years after the 50p level was set. It is time to explore raising that unit price to 60p, because it has to be set at a level where it is effective; it is not there for some kind of virtue signalling. A 60p minimum unit price seems reasonable to me.

I urge the Minister to carefully examine the action that has been taken in Scotland to tackle alcohol harm. It is a basic economic fact that if the price goes up, consumption goes down, and if the price goes down, consumption goes up; it is not rocket science. There are no silver bullets for tackling this issue, but there is some good practice in Scotland. Scotland, as well as England, has to build on what we already know and what we are already doing. I urge the Minister to emulate this practice for the good of the families and the communities who live with this scourge every day, and who need action.

--- Later in debate ---

[Helen Whately]

As I said, I fully appreciate and respect my hon. Friend for the huge amount of work that she does to urge us to recognise the harmful effects alcohol can have.

We know that alcohol misuse can have an impact on hospital care and demand. It contributes to a wide range of conditions including cardiovascular disease, cancer and liver disease, as well as accidents, violence and self-harm. Some 12% to 15% of A&E attendances are alcohol-related, and alcohol is a causal factor in the patient’s diagnosis for more than 1.1 million hospital admissions every year. We absolutely take my hon. Friend’s concerns seriously.

As part of our NHS long term plan, alcohol care teams are being introduced in hospitals with the highest number of alcohol-related admissions. It has been shown that those teams significantly reduce avoidable bed days and re-admissions. The seven-days per week service at Royal Bolton Hospital saved 2,000 bed days in its first year, and modelling suggests that alcohol care teams in every non-specialist acute hospital will save 254,000 bed days and 78,000 admissions per year by their third year of operation.

Thanks to the personal testimony and campaigning by hon. Members present and by others who were unable to attend, the Government have invested £6 million to improve outcomes for children with alcohol-dependent parents. That funding includes £4.5 million for nine local areas to test innovative ways of working and to join up systems to support children and families—promising results are emerging in those areas. We have also allocated £1.5 million to voluntary sector organisations to build resources and capacity at national level, including helpline and contact-centre support through the National Association for Children of Alcoholics. We are also investing £6 million through a capital fund to enable local authorities to improve services and facilities for people with alcohol problems.

We continue to educate the public, ensuring that people are aware of the health risks of alcohol through local and national programmes, such as Public Health England’s One You campaign. The alcohol risk assessment in the NHS health check is used to inform a discussion on reducing the individual’s risk. New guidance encourages referral for liver investigation, where risk is identified. In addition, there is a commissioning for quality and innovation—CQUIN—scheme to incentivise increased cirrhosis and fibrosis tests for alcohol-dependent patients.

My hon. Friend also mentioned labelling. We have worked with industry to communicate the UK chief medical officer’s low risk drinking guidelines on the labelling of alcohol products. The Portman Group and others in the industry have made a commitment that labels will reflect the guidelines and we are closely monitoring progress.

We have also made a commitment in the prevention Green Paper to work with industry to deliver a significant increase in the availability of alcohol-free and low-alcohol products by 2025. A roundtable is being organised to take this work forward. Encouragingly, sales of no or low-alcohol beer are up 30% since 2016 and “nolo” alcohol is set to be one of the driving trends of 2020, although I am sure trends are being reviewed in the light of the pandemic.

Public Health England supports local authorities in their work of needs assessment and commissioning alcohol and drug prevention and treatment services by providing advice, guidance and data. PHE is developing UK-wide clinical guidelines for alcohol treatment. That work will promote good practice and improve the quality of service provision, resulting in better outcomes for patients.

We know that alcohol-exposed pregnancies present a significant public health problem across the country. Foetal alcohol spectrum disorder can have a major impact on the early years development of children and their life chances. There is great work under way at local levels to tackle this. For example, the Greater Manchester health and social care partnership recently launched its #DRYMESTER campaign to raise awareness of drinking alcohol when pregnant. NICE are currently consulting on a draft quality standard on FASD. The voluntary sector also plays a vital role here. As part of the children of alcohol-dependent parents funding programme, over £500,000 is being made available to support work on FASD.

Finally, the good news from the budget is that £46 million in funding is being provided to improve support to individuals experiencing multiple complex needs. That includes tackling homelessness, reoffending and substance abuse, including alcohol misuse. In addition, as part of our rough sleepers programme, there is £262 million of new funding for substance misuse treatment services. When fully deployed, that is expected to help more than 11,000 rough sleepers a year. It will enable people to move off the streets and support them to maintain a tenancy for the long term. The funding complements £237 million announced by the Prime Minister for accommodation for rough sleepers, and a further £144 million for associated support services.

Several hon. Members raised minimum unit pricing, particularly the hon. Member for North Ayrshire and Arran (Patricia Gibson), who drew on her experience in Scotland. There are no plans to implement minimum unit pricing in England at present, but the Government continue to monitor the evidence as it emerges from Scotland and Wales.

Several hon. Members talked about the Government’s alcohol addiction strategy. As announced in November, we are undertaking a UK-wide cross-Government addiction strategy. Plans on the contents of the strategy are being developed and we will have more to say on this shortly.

[Patricia Gibson]

I listened carefully when the Minister said that the Government currently have no plans to implement minimum unit pricing. In the light of that, and given the funding and investment she talks about that will deal with the consequences of alcohol addiction, does she agree that tackling the consequences is less effective than tackling the problem at source? Cider and some of the highest content alcohol is on sale in shops in England for less than a bottle of water or a pint of milk. Does she agree that making alcohol a little bit more expensive could have an impact?

[Helen Whately]

I thank the hon. Lady for her contribution and I take her point. It is important that we continue to look at the evidence and that is the approach we will follow. I thank everyone here today for their contributions to this important debate and for having this conversation.

Historical Stillbirth Burials and Cremations

Patricia Gibson Excerpts

Thursday 6th February 2020 Commons Chamber

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

I am very pleased to participate in this debate today. I echo the thanks that have been expressed to the hon. Member for Swansea East (Carolyn Harris) for securing this debate and for all the work that she has done in this area.

The death of a baby is an extremely traumatic event, which impacts on both parents and the wider family for many years, if not forever. It is not something that can simply be got over. It is an event that families and individuals simply learn to live with. The burial of a child is also very traumatic, but it can, for many bereaved parents and their families, form a very important part of the grieving process, and yet it was only in the mid to late 1980s that the death of a baby was truly starting to be recognised as a major bereavement. Until then, as we have heard some Members mention, any baby who died before birth, regardless of the gestation period, was swiftly removed from the labour ward, and parents were not given an opportunity to see or hold them. Some mothers were sedated after the birth because it was thought that this would help them to forget. It was a generally held view among professionals and, indeed, society that parents should forget their babies and that it was best to carry on as though nothing had happened. Grieving was actively discouraged.

Stillbirth truly was a huge taboo, and we are now gradually starting to break down that taboo and deal with these matters with more compassion and sensitivity. I agree with what the right hon. Member for South Holland and The Deepings (Sir John Hayes) said about the role of fathers in such events. Until fairly recently, fathers of babies who died before birth were pretty much ignored, and their role was considered to be one of merely supporting his wife or partner in her attempts to forget about the lost child and to have another child as quickly as possible. It is genuinely hard to believe that, until very recently, that was how we as a society dealt with stillbirth.

Some parents did not even give their baby a name, because they were not advised that they could or should do so. Some did not even know the gender of their baby, and many had no idea about what had happened to their child’s body. As a result, the grief felt at this traumatic life event was silenced and frowned upon, leading to unnecessary isolation, family breakdowns and poor mental health. It is down in great part to the work of charitable groups such as Sands—the stillbirth and neonatal death charity—that these appalling practices and attitudes, which, these days, are hard to believe, began to change.

Recent years have taught us that, although things are better these days, there can be no room for complacency. We have also learned that there are very different practices in baby cremations across the UK, with some parents receiving ashes from some crematoriums, while others are not. The availability of ashes after cremations seems to have depended on the equipment and cremation techniques used and/or how the relevant authority defined ashes. It seems that there was no statutory definition of ashes in the UK. That has now been rectified in legislation, and we have had legislation in Scotland similar to that mentioned by the Minister.

There is also the issue of parents being told that there were no ashes to be recovered when, in fact, there were ashes, but they were sometimes disposed of without the parents’ knowledge. Indeed, such practices led to investigations in Scotland, going back some decades, at Mortonhall crematorium in Edinburgh.

[Dame Diana Johnson]

I am interested in asking the hon. Lady about the Mortonhall investigation inquiry. Does she feel that that helped parents who had questions about what had gone on and why things had happened in the way that they had? Was it something that she would support for other parts of the United Kingdom in cases where there are still questions that have not been answered?

[Patricia Gibson]

The answer to her question is yes. There is no room for complacency. That investigation led to a whole swath of measures to make sure that nothing like this could ever happen again to parents and that the law would indeed be on their side when similar events occurred in the future. That, I think, is something in which the Minister will take an interest.

The investigation, the Infant Cremation Commission report, and the report of the National Cremation Investigation led to positive change. Now, in almost every circumstance, parents should receive the ashes from their baby’s cremation. A code of practice has been established by a national committee on infant cremation, setting out key principles and minimum standards for all organisations conducting infant cremations.

In March 2015, the Scottish Government announced the appointment of an inspector of crematoriums for Scotland to ensure that all crematoriums were adhering to the current legislation and best practice following the national investigation into circumstances surrounding historical infant cremation practices in Scotland. A criminal sanction was introduced to prohibit the cremation of a foetus, a stillborn baby, or an infant with an unrelated person. Indeed, legislation was brought forward to overhaul policy and practice in the burial and cremation sector, with improved staff training.

We also know that, until fairly recently, the parents of stillborn children were never told where or how their baby had been buried. To us today, that seems almost too cruel to be true and utterly beyond comprehension. I had a stillbirth at full term, and I cannot imagine a situation in which my baby would have been removed from me with no information about how or where he was buried. For the parents affected, that must have made the grieving process much more difficult and much more traumatic. We know that some parents who endured this decades ago can perhaps trace their babies’ graves now, but it is something that they should never have to do. It is probably worse if those parents who seek to trace their child’s remains simply cannot find where they are. Imagine the years passing and the questions growing in their head about where their baby is. I can scarcely believe the attitudes of the recent past that thought this was an appropriate way to deal with the lost babies and grieving parents and families.

We know that some of the babies were buried with other babies, or sometimes with other random adults who had recently died in hospital. Parents trying to trace the burial place of their babies years later are therefore not always successful, which simply adds to the torture and pain despite the passing of years. What is clear is that everything that can be done must be done to assist the parents looking for their lost babies.

These parents were not usually informed that their babies’ loss was officially documented and that they could obtain a certification of the baby’s stillbirth. Such certification can bring some comfort because it is an acknowledgement—a recognition—that their baby existed. Most had not even known that they could name their baby.

Patients in all circumstances were kept in the dark for their own protection. It was assumed that if a mother or father were allowed to see their stillborn baby and establish any kind of connection, it would only prolong their grief, but, of course, we know that parents are committed and connected to their children long before their birth—perhaps at the point of conception, or perhaps even earlier, when they imagine themselves as parents for the first time. We recognise that to lose a baby at any point in pregnancy can be profoundly traumatic.

Today, parents are encouraged to see, hold or even dress their stillborn baby if they choose to do so. They can take photographs, handprints, footprints, and a lock of hair. They are encouraged to collect mementos of their baby and grieve for them, as any parent would grieve for a child, no matter how long their life was. To know that so many couples and families have been denied that chance is heartbreaking and, frankly, difficult to comprehend. Parents who lost babies decades ago still speak of the terrible guilt that they feel about not knowing anything about what happened to their baby, or where they are buried. Sadly, though, they had very little choice in these matters, as, still in the fresh bewilderment of their grief, their babies were simply taken from them and nothing more was said. It is hard to believe that, in the ‘60s and ‘70s, this was, if not mandatory, certainly extremely commonplace, and it sounds as though it was something that would have happened hundreds of years ago.

Thankfully, we are more informed and more enlightened about these matters now. I hope that the relevant authorities in all parts of the UK will do all they can, and continue to do all they can, to help such affected parents to find out where their babies are and give them the support that they need. I know that Sands has done some excellent work in this area. Finding a baby’s resting place will surely provide some peace for many of the bereaved parents and their families—peace that is much needed and to which these parents and their wider family members are entitled.

Thankfully, we all now recognise what a huge and traumatic event it is to have a baby that is stillborn and how it casts a lifelong shadow over parents and wider family members as they cope with the absent presence of a child. Whether we are talking about cremation practices or burials, all parents must be given respect and their babies must be given the dignity of a burial or cremation that involves their families and provides a ritual that can be so important when grappling with overwhelming grief.

We are doing things better, but we must not be complacent on this issue, which is hugely significant for the families and parents left behind. It is right that this important debate has taken place, and I again applaud the hon. Member for Swansea East for securing it.

--- Later in debate ---

[Tim Loughton]

That is really the point that I was looking to make, but my right hon. Friend has done it much more clearly.

If it had not been her intention already, perhaps a takeaway from this debate for the Minister might be to send a communication around maternity departments, and indeed local authorities responsible for crematoriums and others, to express the hope that they would co-operate and to set out the exact extent of the potential issue that we are dealing with.

[Patricia Gibson]

To take the hon. Gentleman back to his earlier point, does he agree that the whole thrust behind instituting coroners’ inquiries—or, in Scotland, fatal accident inquiries—when these events happen is, added to the trauma, the complete lack of co-operation or willingness by hospitals to engage with parents in the appropriate way to give them the answers they need, as was certainly my experience?

[Tim Loughton]

That is right, but again, to give the Department of Health, the NHS and Ministers their due, there have been new innovations in internal inquiries into stillbirths that have made it much easier to get a dispassionate look at exactly what happened and give a full explanation of why it was that a pregnancy apparently without complication resulted in the child being stillborn.

The issue, and the reason my Act is so important, is that in a few complicated cases where the explanation is not sufficient for parents or where not enough disclosure is forthcoming—there has been some resistance from the medical profession; some were not in favour of the relevant clause—the fallback position is that if the coroner sees that there is a case to answer, he or she can launch an investigation, regardless of the view of the hospital or, importantly, of the parents, into whether there was more to the stillbirth that merits inquiry and whether there might be wider lessons, particularly with clusters of stillbirths, as we have had with various scandals in hospitals in this country, to ensure greater transparency.

I think the point I am getting at is that it is in everybody’s interests to have greater transparency, to ensure that we reduce the level of stillbirths, which has been too big a problem for this country compared with other western countries, and we can only do that if everybody has full access to all the information about exactly what the causes might have been. That is my ask of the Minister. Can we chase the Department on why the other bits of my Act have not been introduced yet?

I again pay tribute to the hon. Member for Swansea East, who we are all looking forward to hearing, for bringing together the House on another greatly important matter—a matter that may seem of niche interest, but which is of huge interest to parents who have had their lives so affected by the trauma of a stillbirth, particularly where they do not even know what happened to the body of the baby.

Wuhan Coronavirus

Patricia Gibson Excerpts

Monday 3rd February 2020 Commons Chamber

[Matt Hancock]

The first thing people can do is ring 111, or look on the Public Health England website and the NHS website, which includes links. Critically, people should not go to A& E or to their GP without first calling 111 because they may inadvertently contribute to the spread of the virus, rather than contain it.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

I agree with the Secretary of State that a co-ordinated global response is extremely important, because we know that delaying responses could hasten the spread of the disease. Does he share my concern about reports in The New York Times yesterday, which referred to countries where China holds sway? For example, Cambodia is a magnet for Chinese tourists and workers. Its Prime Minister, Hun Sen, told a news conference that anybody wearing a mask would be kicked out of that conference because it would create a climate of fear. Does the Secretary of State share my concern that that does not bode well for trying to slow down the spread of this disease?

[Matt Hancock]

I have not seen that report, but I will look into it.

Oral Answers to Questions

Patricia Gibson Excerpts

Tuesday 28th January 2020 Commons Chamber

[Jo Churchill]

No woman should be denied access to vital screening. I believe that my hon. Friend is referring to a particular matter in her constituency where it has been very difficult for somebody to access screening. I am happy to meet her to see how we can work through this. We are actually working on a home kit for cervical screening, which should help in time, but nobody should be denied access. We are committed to improving access for all women, and I will be happy to meet her to see what we can do.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

13. What recent representations he has received on people affected by the hormone pregnancy drug, Primodos.

[The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)]

Ministers have not received any recent representations. However, as we know, Baroness Cumberlege is leading the independent medicines and medical devices safety review, which includes an examination of what happened in the case of Primodos. Her review has had lengthy engagements with people who have been affected.

[Patricia Gibson]

As the Minister is aware, the hormone pregnancy drug test Primodos was taken by around 1.5 million women in the ‘60s and ‘70s, leading to birth defects, miscarriage and stillbirth, and, 50 years on, those affected still wait for justice. The review into this scandal, announced in 2018, was very welcome, but can the Minister confirm that, if it is merited, she is open to establishing a comprehensive public inquiry following the publication of the review to ensure justice for those affected?

[Ms Dorries]

Baroness Cumberlege’s review is examining what happened in the case of Primodos and will determine what further action is required. Ministers will consider any recommendations very carefully. We do not have a date for the publication of the review, but it will be very soon. Perhaps we can continue the conversation then.