Oral Answers to Questions

Paul Sweeney Excerpts

Tuesday 29th October 2019 Commons Chamber

[Matt Hancock]

How could I say no as my wife was an osteopath? I understand very strongly the importance and value of those professions.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

T10. The Royal College of Surgeons reports today that 61% of consultant surgeons have been told not to take up waiting list time reduction initiatives over the winter because of the NHS tax trap. Will the Secretary of State please engage with the Treasury and appeal to it to sort this out before waiting lists are exacerbated over the winter months?

[Matt Hancock]

I am of course engaged with the Treasury on this, but I would also say that these flexibilities are available right across the country and they must be used by trusts.

Baby Loss Awareness Week

Paul Sweeney Excerpts

Tuesday 8th October 2019 Commons Chamber

[Ms Dorries]

I have already sent a message to my team asking why the test is not being done in Scotland and what we can do to ensure that it is rolled out across the UK. If I can have those conversations with the devolved Administration, I certainly will, and I will certainly push that from my end and in my Department.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

I share the sentiments of the hon. Member for North East Fife (Stephen Gethins): collaboration is critical. One of my constituents raised with me concerns about the fact that there was no peer-to-peer support provided by the medical profession. She was dealing with her GP, but she relied for support on the charity SiMBA—Simpson’s Memory Box Appeal—a friend having referred her. Maximum co-operation and support are critical. Hopefully, we can share as much information as possible, so that we avoid people feeling that they are alone, or not being given the support that they need. I was shocked to hear what happened to my constituent. I would be keen to ensure co-operation and to promote it as much as I can.

[Ms Dorries]

I thank the hon. Gentleman for his contribution, but I only have a few minutes left, so I have to move on.

My hon. Friend the Member for Eddisbury asked what we are doing to eliminate the stigma around mental health. As the Minister for Mental Health, I can say that we are doing a huge amount. I do not know whether anybody in the Chamber has managed to see it yet, but a campaign video was released this week called “Every Mind Matters”, which the royals kindly voiced over. It was written by Richard Curtis and features many celebrities, including Davina McCall. It is all about people who everybody knows and recognises talking about their own mental health issues, to break down the stigma. That is just one of the many campaigns that are taking place.

As I said in the debate on women’s mental health last week, when somebody breaks their leg, we put a plaster cast on the leg, and that is fine. When someone has a mental health issue, they do not want to talk about it. I hope that the stigma is reducing and that there is parity and equality between mental health and physical health. Campaigns like “Every Mind Matters” are getting us there.

Oral Answers to Questions

Paul Sweeney Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Jackie Doyle-Price]

I do not share the hon. Gentleman’s view on this. Clearly, it is important for CCGs to have the freedom to determine their best primary care arrangements. Walk-in centres are convenient for people who are in work and who perhaps work away from home, but ultimately, we keep people with disabilities in work by having bespoke support for them, and that is better organised by having good primary care services near the home.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Matt Hancock)]

This week, the Department has released a consultation on the future of clinicians’ pensions, a new five-year deal to support our approach to community pharmacy, the Government’s prevention Green Paper and a £20 million collaboration with the Prince’s Trust on the NHS widening participation initiative, which will allow and support more apprentices into the NHS. There has been a lot done just this week, and there is a lot more still to do.

[Mr Sweeney]

Another item for the Secretary of State’s list might be to engage with his counterpart in Scotland on the issue of the NHS taper on the pensions programme. When I raised the issue with a Treasury Minister, she seemed unaware that there was more than one NHS in the UK. If there is some co-ordination and joint representation to the Treasury, that might assist matters. Would the Secretary of State agree?

[Matt Hancock]

Of course, in solving this problem, many of the changes can take place within the NHS, and we are working on that with the Treasury. I am happy to ensure that discussions take place with devolved colleagues, but of course, the NHS is devolved in Scotland.

Drug Treatment Services

Paul Sweeney Excerpts

Tuesday 16th July 2019 Westminster Hall

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

Thank you for calling me to speak, Mr Hollobone. I congratulate my hon. Friend the Member for Manchester, Withington (Jeff Smith) on an excellent introduction to the debate and on the vital points he made.

Last week, one of my constituents, Chelsea Bruce, died of a drugs overdose. She was 16-years-old. She is another figure to add to the 1,187 deaths in Scotland in the last year. It is particularly poignant because this time last year I presented Chelsea with an award at her school, where I talked about the potential of the future and what young people could go off and do in the world. To think that that girl now lies dead for entirely preventable reasons sickens me. I wonder about the damage that has been caused to her family and the trauma that has been caused to her friends, who now live in a mixture of grief and fear of what drugs can do to them.

Chelsea might not have come to harm had she been able to have the pills tested, to have had a testing kit or to have sourced the pills from a supplier who had had them tested. There are now very high-strength MDMA pills in circulation. Sometimes it is not MDMA but other substances that mimic some of the effects of MDMA; that could have been a factor in Chelsea’s death. That is something we need to understand in this House and respond to with great urgency.

I have been following the campaign for drug policy reform closely since my election, and ensuring that a public health approach is at the heart of how we begin to properly tackle this devastating blight on our country is critical. I am personally convinced of the merits of decriminalisation of people who use drugs and minor drug possession for personal use, based on international examples, most notably in Portugal. I am pleased that the introduction of safe drug consumption facilities is Labour party policy and we will be campaigning to ensure that we go even further in our next manifesto.

However, I am alarmed at the lack of impetus to put in place practical policies now, which could save lives in my city where drug-related deaths have reached epidemic levels. They are now 1,000% higher than the European average; that is a public health emergency by any definition. While many are big on rhetoric, our public policy is years behind where it should be in addressing this appalling crisis of death and misery.

The Home Office and the Lord Advocate have been intransigent about the piloting of safe drug consumption in Glasgow. A model that has a worldwide track record of saving lives has been discussed. While the Home Office refuses to change the obsolete Misuse of Drugs Act 1971, the Lord Advocate, Scotland’s chief law officer, claims that a letter of comfort is insufficient to avoid possible prosecutions of NHS staff who might work in such a facility or those who would use it, unless the law is changed by the UK Government.

The chief executive of the Scottish Drugs Forum, David Liddell, believes that much more can be done to facilitate reform within current legislation. Last week, I suggested to the Scottish Affairs Committee that the Lord Advocate is being too risk averse and conservative in approach. I have now written to the Lord Advocate to challenge him on that point. It is certainly no good for Scottish Government Ministers and Glasgow City Council to abrogate their responsibility for this public health crisis by conveniently blaming Westminster, as unco-operative and unhelpful as it might be on this issue, when they have cut victim services in Glasgow by over a quarter in recent years, causing the closure of rehabilitation services and needle exchanges, as well as the end of central Government funding for the national naloxone programme.

While a heroin-assisted treatment pilot will launch in Glasgow later this year, it will be highly targeted and the thresholds for access will be difficult to reach for most of Glasgow’s problematic opiate and cocaine users, who are often polydrug users. That is why I have also asked for the Lord Advocate’s advice on an additional innovative model that could be adopted in Glasgow, a safe prescribing clinic, where instead of illicit drugs of an unknown purity being brought into the facility for use under clinical supervision— as in a drug consumption room—pharmaceutical diamorphine and cocaine can be prescribed freely for use in a supervised clinical environment. As well as bringing all the benefits of DCR, it removes the stranglehold that criminal gangs have over the drugs supply chain and removes the financial dependency that many people with drug problems face to feed their habit, and the crime that goes with it. Combine that with supervised drug facilities like the Loop in Bristol and WEDINOS in Wales, and we could be on to something that reduces harm.

Saving one life is one life that is worth it, and we should take urgent action now.

--- Later in debate ---

[Seema Kennedy]

As I say, that is a matter for the Home Office. I sense the hon. Lady’s frustration, but I am not responsible for that area. I have already said twice that I am happy to take that point away. Tabling business in the Chamber really is not my responsibility. I sense and am cognisant of the frustration in the House.

Under the 2017 drug strategy, we are involved in delivering actions across four themes: reducing demand to prevent drug use and its escalation; restricting supply; building recovery; and a new strand focused on global action, which is important. We need a partnership-based approach alongside the treatment system; other partners, such as the mental health and criminal justice systems, have key roles to play in securing the drug strategy’s aims.

I attend a cross-ministerial drug strategy board with Ministers from the Ministry of Housing, Communities and Local Government, the Home Office, the Ministry of Justice and representatives of Public Health England. Additionally, the Home Secretary has appointed Professor Dame Carol Black to lead a major review of drugs, looking at a range of issues, including the system of support and enforcement around drug misuse, to inform our thinking about tackling drug harms. Dame Carol will report later this summer.

I acknowledge the concerns about the funding of public health services, and that local authorities need to make difficult choices about how they spend their money to be able to continue providing effective drug treatment services. Local authorities will receive £3.1 billion in this financial year, ring-fenced exclusively for use on public health, including drug addiction. In addition, we are investing more than £16 billion for public health over the five years to the end of 2020. It is a condition of the public health grant that local authorities have regard to the need to improve the take-up and outcomes from drug and alcohol misuse treatment services. Public health funding is a matter for the next spending review, in which it will be looked at in the light of the best available evidence.

[Mr Sweeney]

Does the Minister accept that it is within the remit of the Department of Health and Social Care to consider the possibility of not only drug consumption rooms but expanding the scope, based on a heroin-assisted treatment facility, to provide safe prescribing clinics, which have far lower thresholds and which would provide greater access to safe drug use?

[Seema Kennedy]

I will have to respond to that in writing.

It is not possible for the treatment system to bear sole responsibility for responding to these challenges. Where necessary, the Government are prepared to act to ensure that our response enables us to reduce the harms caused by drugs. We are already acting on designating third-generation synthetic cannabinoids, such as Spice, as class B drugs under the Misuse of Drugs Act. In response to the increase in drug-related deaths, PHE has been working to better understand how to best protect people from dying of overdoses.

Although we have made strong progress in tackling the human and financial harms associated with drug misuse, we know that there is more still to do, and that there are emerging challenges that we need to tackle. We will approach these issues with the full range of partners who are essential to delivering the drugs strategy, enabling us to build on such achievements—without being complacent—and drive further progress.

NHS Pensions

Paul Sweeney Excerpts

Wednesday 26th June 2019 Westminster Hall

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

Thank you, Mr Gray, for your kindness in letting me participate in the debate. It is, as always, a pleasure to serve under your chairmanship. I apologise for my late arrival.

I congratulate the hon. Member for Poole (Sir Robert Syms) on securing the debate, and the hon. Member for East Renfrewshire (Paul Masterton) on also trying to press the Government on this matter. I have come to the debate because two consultants in my constituency came to me about this issue and I thought it important to communicate their views directly to the Minister. I hope that actions can be taken, because this is clearly a classic case of the law of unintended consequences.

One of those constituents, Dr Urquhart—the other was Dr Hepburn—wrote to me. Dr Urquhart has been a consultant in the NHS Greater Glasgow and Clyde area for nine years and is employed on a 48-hours-per-week, full-time contract, which includes being on call. He says that, following this change,

“I will have to drop the number of hours per week I work and also not take on any extra shifts which are paid…to cover rota gaps and waiting list initiatives which reduce the penalty to NHS GGC for waiting list breaches.”

In a sense, the change is penalising the efficiency of the NHS and introducing further costs to the health service that could be avoided. The consultant continues:

“Due to reduction in annual allowance for pension growth, the introduction of the tapering of the annual allowance coupled with the introduction of the 2015 NHS pension scheme, a growing number of doctors are facing four, five and six figure tax bills on top of their income tax and national insurance contributions. In my case this means that in the next year I expect a huge tax bill as in October 2018 I received a 10 year pay rise and will receive a large tax bill.”

He believes that it will impact on all consultants in NHS Greater Glasgow and Clyde and beyond.

It appears that the only way in which Dr Urquhart can avoid these large regular tax charges, which may amount to tens of thousands of pounds a year in addition to his income tax payments, is to reduce the hours that he works for the national health service. He fears that many of his colleagues will be forced to accept the same conclusion. He and his colleagues often go above and beyond to ensure that services can continue running safely and effectively, but there are limits to what can be reasonably expected of even the most dedicated doctors.

As a result of the current pension and tax regime, Dr Urquhart is effectively paying to provide additional services to the national health service. He hopes that these separate changes to tax and pension arrangements were an unintended consequence that was not appreciated when they were first introduced, that the resultant negative effects on the NHS workforce were unintended, and that the Treasury will undertake to correct them. Like many services, his department relies on consultants working regular overtime through additional programmed activities.

Unless the Government take action, many doctors like Dr Urquhart will be left with no option but to reduce their working hours significantly. Other consultants in the national health service in Glasgow are being advised to take early retirement to avoid these taxes. That will exacerbate an already acute workforce crisis in NHS Greater Glasgow and Clyde and seriously jeopardise the sustainability of the national health service. The impact on Glasgow’s Queen Elizabeth University Hospital —the largest medical facility in Europe—alone must not be understated. The topic is frequently discussed by his colleagues, many of whom feel the same.

I hope that the Minister will take cognisance of the issues raised by many consultants and the British Medical Association. Fundamental reform of the tax issue, particularly by scrapping the tapered annual allowance, is urgently required to prevent a workforce crisis. I hope that he will recognise the scale and immediacy of the risk to the national health service and that he will undertake to take our representations back to the Government and ensure that the problem is rectified as a matter of urgency.

--- Later in debate ---

[The Minister for Health (Stephen Hammond)]

As ever, Mr Gray, it is a pleasure to see you in the Chair for this important debate, and I congratulate my hon. Friend the Member for Poole (Sir Robert Syms) on securing it. It is a topic that the House has previously considered, when my hon. Friend the Member for East Renfrewshire (Paul Masterton) introduced a debate on the matter.

Colleagues should be reassured that the Government have been listening carefully to senior doctors and their employers. We recognise the actions clinicians are taking in response to their concerns about, and experience of, the annual allowance tax charges and how they are affecting frontline services. My hon. Friend the Member for Poole is right: although we are talking about tax changes for consultants, clinicians and GPs, the reason why this is so serious is that ultimately, if we do not get it right, it impacts on the quality of patient care. We all share that ambition to get it right.

[Mr Sweeney]

The Minister says that the tax changes are likely to have an impact on patient care. They are already having an impact; my constituent has said that he is seeing anaesthetic cancellations on theatre lists at his hospital in Glasgow, which have never been seen before in the NHS. He has had to resign as a foundation programme director, supervising junior doctors, to reduce the number of paid hours he does.

[Stephen Hammond]

Let me make it clear that not only are the changes having an impact, they are likely to continue to have an impact. I recognise that; the hon. Gentleman will hear later in my remarks that we recognise that point.

My hon. Friend the Member for Poole was right to talk about the long-term plan and the cash settlement that goes with it. He was also right, though, to mention that any plan will work only if it works: if we make sure the people delivering it can do so with the numbers and experience required. The hon. Member for Newport West (Ruth Jones), although she said she was not expecting to speak this morning, made a thoughtful speech and raised a number of issues from her direct experience that informed the debate.

My hon. Friend the Member for Winchester (Steve Brine) represents the place where I was born and spent my childhood, so for that and other reasons, I always listen carefully to what he says. He was right to stress at the start of his speech that this is not about tax breaks for particular people, although that is the headline; the reality is that perverse disincentives are being created against providing the care that we need. I listened carefully to the hon. Member for Glasgow North East (Mr Sweeney), who has just intervened on me to reiterate the point he made in his speech about the experiences of some consultants, and I recognise that those experiences are not unique to Glasgow North East.

The hon. Member for Central Ayrshire (Dr Whitford) always makes many informed remarks, given her experience. She made a point that perhaps has not been picked up, but is important in informing the debate: this is not just about losing a number of potential outpatient appointments and clinicians to service them, but about the impact on training. In many of the places that I have had the honour to visit as Health Minister, it is clear that the mentoring and support provided by senior staff to more junior staff is an important contribution, not only to the wellbeing of those junior staff, but to their education and, therefore, to the benefit of patients. That is undoubtedly one of the consequences of what we are talking about today.

NHS Pension Scheme: Tapered Annual Allowance

Paul Sweeney Excerpts

Tuesday 2nd April 2019 Westminster Hall

[Paul Masterton]

That is exactly right. I asked for a Treasury Minister to reply to this debate, because the underlying legislation is a Treasury issue, but it is important to have a Health Minister here today to hear at first hand the stories that are being raised by MPs.

In recent months, it has become increasingly apparent that the pension tax rules are resulting in unexpected tax charges being levied on a large number of GPs, senior doctors, surgeons and consultants right across the UK. I believe that if the issue is not addressed, serious capacity gaps in the NHS will only be made worse.

In Scotland, 7.6% of consultant posts are vacant, and more than half of those have been vacant for more than six months. There is a similar picture in the NHS in all other parts of the United Kingdom. In a recent survey by the Hospital Consultants and Specialists Association, more than 40% of the doctors questioned said that pension taxation changes had led them to change their plans and retire earlier than expected.

The way in which the tapered annual allowance operates means a significantly reduced annual allowance ceiling is hitting many of the NHS professionals that I, and the hon. Member for Strangford (Jim Shannon), mentioned in their mid to late careers. As their entire income is taken into account for the purposes of tapering, the threshold can be breached even by doing non-pensionable work, including covering for absent colleagues, extra programmed activities or waiting list initiatives. NHS staff on pay-as-you-earn cannot avoid the notional pension input amount calculation. As a result, many consultants are being hit with unexpected five-figure tax charges. A number are now dropping extra work, turning down hours or going part-time to negate or avoid the penalties.

Of course high earners should pay their fair share, and all the doctors who have contacted me want to do so, but they are paying rates of more than 60% as a result of the taper. Some are paying effective rates of more than 100%. Many consultants who continue to do non-pensionable overtime are effectively paying the Government to go to work, while receiving no additional pension benefit.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

The hon. Gentleman is making a powerful, forensic speech on this critical issue facing the national health service. Several of my constituents have been in touch about it. One consultant mentioned that the impact of this issue on NHS Greater Glasgow and Clyde will be huge, because waiting list initiatives ensure that the health board does not receive penalties, so it militates against efficiency in the national health service and will cost more in the long run. It is a total false economy. Surely the Minister can take action with the Treasury to get this sorted out quickly.

[Paul Masterton]

The hon. Gentleman raises a good point. Our constituencies share a health board. The examples of people who work for NHS Greater Glasgow and Clyde show exactly the consequences and knock-on effects.

One surgeon contacted me to tell me that he was hit with a tax bill of £62,000 because he received a national award. People who receive a bonus or a pay rise can find themselves with a whopping tax penalty as a consequence. Rigid pay and pension rules in the NHS mean that their ability to mitigate the issue is pretty much non-existent, certainly compared with people in the private sector, because there is not the flexibility to reduce contributions or request cash in lieu of pension if there is a danger of breaching the allowance. The only option, as we have heard in Members’ examples, is to opt out of the scheme altogether or drastically reduce working hours. This issue is becoming a huge driver not only of early retirement, which in itself is extremely serious, but of enforced reduced working hours. That is having an impact on NHS care and creating lost capacity. Waiting times, which are a problem in various areas across the UK, are hit because these perverse rules mean that consultants refuse the overtime that is needed to help clear the backlog.

The investigation by the Financial Times found that the issue had increased the risk of delays in cancer diagnosis in some parts of the UK and lengthened waiting times for procedures such as hip replacements. Critical areas such as intensive care and radiology are also being affected. One consultant said that about 50 fewer patients were being seen per week in the cancer clinics they cover, as a result of doctors turning down extra shifts.

A consultant who lives in my constituency contacted me following receipt of a tax charge of £29,000, despite doing no work outside the NHS. He told me that he will now have to drop a session of clinical work to try to ensure that it does not happen again, and that he is actively considering early retirement, having reluctantly started to reach the conclusion that there is no incentive for him to continue his career beyond the age of 60. He has been forced into that position by the clear unintended consequences of the pension system.

Licensing of Medical Devices

Paul Sweeney Excerpts

Tuesday 12th February 2019 Commons Chamber

[Owen Smith]

The hon. Gentleman, who has also done excellent work on mesh as co-chair of the group, is completely right.

Our regulatory system for these devices, including mesh, is more akin to the system that applies to toasters or plugs, and the way in which they get kitemarks, than to the way in which medicines are approved. It is so problematic that, last year, the journalist I was talking about applied to get a kitemark—known as a CE mark—for surgical mesh. However, the item in question was a bag that had previously been used to keep oranges in, but they still succeeded in getting a CE mark for it. It obviously was not put into a woman, but real mesh has been and is being put into thousands of women all over the world, including those suffering from organ prolapse and stress urinary incontinence. The real impact of the mesh has been revealed in the chronic pain, disability and even death suffered by many women as a result of the mesh warping, breaking, morphing, changing its constitution and cutting into organs inside the body. This was revealed only after years of sales.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

My hon. Friend is making a powerful speech about the devastating impact that mesh has had on women. I discovered the real impact of it when a constituent came to visit me on Friday. Wendy talked about the impact that it had had on her life. She said that she had been concerned about the mesh and had discussed it with her surgeon, who had insisted that it was not mesh but tape. She was therefore misled by a medical professional. Does my hon. Friend agree that that is another worrying aspect of how these medical devices are being marketed and communicated to patients?

[Owen Smith]

Yes, I absolutely agree. There are many instances of similar mis-selling of these products to women. We need to examine the relationship between the doctors who are selling or marketing these products to their patients and the companies that develop them. Some have an interest in those companies, and others are getting a money benefit through doing this in the private sector. All these things desperately need to be looked at.

The terrible truth is that the surgical mesh scandal that is unfolding is just one of the scandals relating to medical devices. We had the metal-on-metal hip joint scandal, with metallosis poisoning people’s bodies. We had the scandal of textured PIP breast implants poisoning women’s bodies. Those implants are now connected with increased incidences of cancer. We had spine-straightening devices for children that were only ever tested on corpses. We had pacemakers such as the Nanostim, which was designed to sit inside the heart and work for up to 19 years. It has now been removed from the market because the batteries started to break down and cease to work and, worse, it was giving people electric shocks. The devices are now being cut out of people. Between 2015 and 2018, UK regulators alone received reports of 64,000 adverse events involving medical devices. A third of those incidents resulted in serious medical repercussions for patients, and 1,004 resulted in death.

Social Care Funding

Paul Sweeney Excerpts

Wednesday 17th October 2018 Commons Chamber

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

In my constituency, the Barchester Alexandra Court Care Home has closed, with 53 residents losing their places. That was because Glasgow City Council’s funding has been cut by 10%, yet the discretionary spend for Scottish companies has been cut by only 5%. Surely that is a disproportionate cut in social care in Scotland. Although the objectives are laudable, we have seen continued pressure on social care in Scotland as in the rest of the UK.

[Dr Whitford]

There is no question but that there is pressure. There is no question but that all the systems face the pressures of increased demand, workforce and money, but if the hon. Gentleman would like us to match funding down here, then we will remove £881 million from our health budget and, obviously, that £157 a head from our care budget. We spend more per head of population in Scotland—considerably more. [Interruption.] That is one of the mantras that is always heard down here, but may I point out that, for a Barnett consequential of 9.3%, the Scottish Government have to manage one third of the UK landmass—that is roads, rail, GP practices, hospitals and schools.

Autism

Paul Sweeney Excerpts

Thursday 29th March 2018 Commons Chamber

[Mr Sheerman]

My hon. Friend is absolutely right. Interestingly, as has been said, this goes right across the whole spectrum. Of course, having access to healthcare is important. Access to education is important, especially when there is a very supportive environment for a child on the autism spectrum at primary school and then going to “big school” is a very big challenge for them. We need to get this right, and support families to support the child at that time.

Recently, many Members were part of the campaign for Lauri Love, a severely autistic, wonderful young man who was in danger of being extradited to the United States. Anyone who met Lauri Love and understood his condition was sympathetic. At the moment, it looks as though we have been successful in supporting Lauri, so that is a great victory.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

I was actually at Glasgow University at the same time as Lauri Love, and I remember him well from those days. The situation that my hon. Friend mentions is critical and exactly what we now need to tackle in the UK. We need a national approach, including engaging with the devolved Administrations, to ensure that there is a proper policy framework to safeguard the rights of autistic people across the workplace and in other forms of public life.

[Mr Sheerman]

My hon. Friend is right. We need to spread the knowledge. We need to get the Government, right across the piece—there almost ought to be a Minister for autism—making sure that seamlessly, across all Departments, there is a high level of awareness.

On early diagnosis, the commission heard evidence on what happens in Sweden. Sweden seems to be one of the places that one looks to: I believe that the professor we interviewed was the man who actually minted the expression, “the autism spectrum”. The evidence we were given was that every child in Sweden is evaluated to see whether they are on the spectrum very early on—at seven years of age, I think—so why not every child in the United Kingdom? That is what we should be looking for—early diagnosis and early support of the family.

A lot of people on the autism spectrum fall foul of the criminal justice system. A person on the autism spectrum can get on a bus in a normal way in the morning, then if the bus is cancelled or something else happens that disturbs their routine, that has a very big impact on them. They may behave rather antisocially. The police may be called and they end up in a cell. I have heard this story so many times. The criminal justice system has to look very carefully at the needs of people on the autism spectrum.

GP Recruitment and Retention

Paul Sweeney Excerpts

Wednesday 28th March 2018 Westminster Hall

[Bridget Phillipson]

I am happy to hear that my hon. Friend was successful in his campaign, but we are seeing closures and mergers of practices across the country, and we need a much broader solution. It should not fall only to local campaign groups or local NHS managers to try to put right some of the broader systemic problems in our health service.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

My hon. Friend is making a powerful speech about not just patchiness but the consistent pattern we see across the country. It is not simply down to people being too picky about who their GP is. In Scotland we have seen the number of GP practices fall from 1,029 when the Scottish National party came into power in 2007 to just 956. We have seen the number of GPs increase by only 1% in Scotland, but the size of GP practice lists has increased by 7%. The root cause is one of supply and demand; we are not getting enough GPs to come into the sector when more and more are retiring all the time.

[Bridget Phillipson]

I agree with my hon. Friend and I am sure his constituency, in common with mine, has significant problems with industrial illness and long-standing health problems, which means that we do not need just the national average number of GPs, or just enough to get by. To deal with the health need we face in the local population, we need a much better service to ensure that we drive down some of the health inequalities that most seriously affect communities such as mine and, I am sure, his.

More generally, constituents are also worried that changes to the GP workforce at their local practice are producing a less effective service. Many are concerned by rates of retirement, especially among family doctors with whom they have built up a close relationship over many years. They also believe that the overall decline in the number of family-run practices resulting from retirements is damaging the continuity of care they expect from their local practice.

On the securing of timely appointments, constituents who work full time are frustrated by restrictive booking systems and a lack of availability in the evenings and at weekends. Others complain that constraints in the system mean that the 10-minute consultation period is so strictly enforced that multiple appointments are necessary just to outline the problems that they face. Their frustration grows if they cannot see the same doctor on each occasion and have to repeat the same problems time and again.

There is a general sense among my constituents, and indeed in the comments posted on the House of Commons Facebook page ahead of this debate, that the pressures on general practice will only increase as more new homes are built in communities where public services are already under pressure.