Health and Social Care
Paula Sherriff Excerpts(4 years, 5 months ago)
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Paula Sherriff (Dewsbury) (Lab)
Last week it was reported that a 16-year-old boy in Milton Keynes tragically died by suicide. His referral to mental health services was rejected because he did not meet the threshold as his mental health problems were not deemed severe enough. This is deeply shocking, and it is clear that too many children are going without the support they need. Will the Minister now match Labour’s commitment to invest in children’s mental health services and to ensure that every secondary school has access to a trained mental health professional?
Ms Dorries
Obviously I cannot comment on an individual case, but what I can say is that the NICE guidelines on assessment for suicide were recently sent out to A&E departments to ensure that people who present with mental health problems are treated holistically and looked at in the round to assess whether they are a suicide risk.
We are investing £2.3 billion in mental health services—more than invested by any previous Government—and a huge amount of that is going towards children and young people. I hope cases such as the one highlighted by the hon. Lady will be a thing of the past. We have turned a corner. We are rolling out these mental health teams and, in the last year alone, 3,000 more people are working with young people and young adults. We have the new training scheme and the school mental health support teams. There is more to be done, but I hope such stories will become a thing of the past.
[Official Report, 29 October 2019, Vol. 667, c. 188.]
Letter of correction from the Under-Secretary of State for Health and Social Care, the hon. Member for Mid Bedfordshire (Ms Dorries):
An error has been identified in the response I gave to the hon. Member for Dewsbury (Paula Sherriff).
The correct response should have been:
Oral Answers to Questions
Paula Sherriff Excerpts(4 years, 6 months ago)
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Ms Dorries
I thank my right hon. Friend for his question and for his work as Secretary of State. He was the longest-serving Secretary of State for Health ever, and he is passionately interested in this subject, too. Yes, we are on track—in fact, we are more than on track—to meet our objective of 25% of schools being covered by a school mental health support team by 2023-24.
The school mental health support teams have been launched in trailblazer areas, and I visited one a few weeks ago at Springwest Academy in Hounslow to see the amazing work the teams are doing with young children. The teams are teaching coping strategies and identifying mental health problems as they arise very early in life, which helps children to deal with those mental health problems now and into adulthood. We are on track and we hope to meet that objective.
Paula Sherriff (Dewsbury) (Lab)
Last week it was reported that a 16-year-old boy in Milton Keynes tragically died by suicide. His referral to mental health services was rejected because he did not meet the threshold as his mental health problems were not deemed severe enough. This is deeply shocking, and it is clear that too many children are going without the support they need. Will the Minister now match Labour’s commitment to invest in children’s mental health services and to ensure that every secondary school has access to a trained mental health professional?
Ms Dorries
Obviously I cannot comment on an individual case, but what I can say is that the NICE guidelines on assessment for suicide were recently sent out to A&E departments to ensure that people who present with mental health problems are treated holistically and looked at in the round to assess whether they are a suicide risk.
We are investing £2.3 billion in mental health services—more than invested by any previous Government—and a huge amount of that is going towards children and young people. I hope cases such as the one highlighted by the hon. Lady will be a thing of the past. We have turned a corner. We are rolling out these mental health teams and, in the last year alone, 3,000 more people are working with young people and young adults. We have the new training scheme and the school mental health support teams. There is more to be done, but I hope such stories will become a thing of the past.[Official Report, 5 November 2019, Vol. 667, c. 8MC.]
Baby Loss Awareness Week
Paula Sherriff Excerpts(4 years, 6 months ago)
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Paula Sherriff (Dewsbury) (Lab)
Today’s debate has been incredibly moving and I am humbled to respond on behalf of the Opposition. It of course coincides with Baby Loss Awareness Week, which is an important opportunity for us all to unite with bereaved parents, and their families and friends, to commemorate the lives of babies who died during, before or shortly after birth.
I congratulate every Member who has had the courage to speak today about something as personal and devastating as baby loss. Drawing from our own personal experiences will undoubtedly help and bring comfort to the thousands of others who have been affected by this important subject. As you said earlier, Madam Deputy Speaker, today’s debate has once again shown Parliament at its best. I wish to reflect on some of the moving contributions we have heard.
Let me start by thanking the hon. Members for Colchester (Will Quince) and for Eddisbury (Antoinette Sandbach). The hon. Member for Colchester could not speak in this debate as he is now a Minister, but his bravery in bringing this issue to the House was remarkable. Collectively, we thank both Members for their incredibly hard work and great courage. On behalf of the official Opposition, I thank you both from the bottom of my heart.
The hon. Member for Banbury (Victoria Prentis) spoke very knowledgably about the work being done by the Department for International Development in developing countries, which was very heartening. My hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) spoke very powerfully about how important it is that we support bereaved parents—I will go on to talk a bit more about that in a moment.
The hon. Member for Brigg and Goole (Andrew Percy) talked about bereavement suites in hospitals. That is an incredibly important issue and, indeed, it is something that I will take back and discuss with my own trust. My hon. Friend the Member for Rotherham (Sarah Champion) discussed both counselling and family support. The right hon. Member for South West Surrey (Mr Hunt) spoke very knowledgably about the impact on health professionals and how it must simply be one of the worst things that they ever have to deal with.
The hon. Member for North Ayrshire and Arran (Patricia Gibson) spoke so powerfully about her own experience and, once again, showed great bravery. She also discussed how important it is that we are all aware of, and that we empower others to learn about, pre-eclampsia. We also heard from the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) and from the hon. Member for Strangford (Jim Shannon) who gave us a very, very moving speech. I thank him very much once again for his incredible bravery.
All the charities that come together to collaborate on this commemorative event do amazing work supporting bereaved families. There are now more than 60 charities involved, and they have a huge impact on raising awareness nationally, and each organisation should be incredibly proud of everything they do and everything they have achieved in driving this agenda forward.
As well as using today’s debate to raise awareness, this is an opportunity to reassess the progress that is being made and to highlight the fact that, although excellent care is available in the country, it is not available to everyone everywhere. Every year, thousands of people experience the loss of a baby in pregnancy, at or soon after birth, and in infancy.
Unfortunately, it is not a rare event, and, as too many of us here know, it can happen to anyone. The Miscarriage Association has invited women to share their experiences, and the bravery of these women in sharing their stories is commendable. Angela has spoken about how her mental health deteriorated after her second and third miscarriages. She said:
“My mental health deteriorated after those two losses. I needed medication to get through my periods when they returned. I couldn’t go to the GP or the hospital without having a panic attack. I had horrible flashbacks of the miscarriages themselves. And although these subsided over time, I can still have a panic attack at the GPs without warning. It also started to affect me at work and in my personal life, because my self-esteem and self-confidence plummeted and I lost the ability to believe that I could do anything right. It was almost like when I lost the babies, I also lost some of myself.”
She has also spoken of the difficulty in talking about miscarriage and mental health, but the importance of doing so. She went on:
“I have also confided in a few close friends and that helps too. I still struggle asking for help, it is not something that comes easily to me, but I when I do, I am always grateful that I tried. It’s hard to break the silence around miscarriage and even harder to break it around mental health and miscarriage combined but I think we should try. Even if it just helps one person feel a little less alone.”
Unfortunately, there remains a tremendous taboo around baby loss, and many women report that their family and friends do not want to talk about their loss, and that can lead to an isolation and a disconnection from others, which means that parents can end up trapped by their own grief.
There is work to be done to break down the unacceptable stigma and, too often, feelings of shame that can surround baby loss. Whatever the circumstances around the loss of a baby, every single woman deserves respectful and dignified care that acknowledges her loss, supports her mental health and empowers her to make future decisions about having a child.
The care that bereaved families receive from health and other professionals following pregnancy loss or the death of their baby can have long-lasting effects. Good care cannot remove parents’ pain and grief, but it can help them through such a devastating time. In contrast, poor care can significantly add to their distress. Unfortunately, the standard of care in the UK varies between regions and even within settings, depending on the stage at which a loss occurs—from early pregnancy through to infancy. Although there is excellent care available in this country, it is not available to everyone. In England alone, there is still a 25% variation in the stillbirths rate and, as a result, many parents do not receive the good-quality bereavement support that they so desperately need after pregnancy or baby loss, and we have heard this afternoon what a difference that that can make.
We need to ensure that there is learning from every single miscarriage and stillbirth. Although we can rightly say that we are beginning to improve the approach to those dealing with the consequences of baby loss, it seems like we still have a way to go in understanding and really tackling its causes. According to The Lancet, the annual rate of stillbirth reduction in the UK has been slower than in the vast majority of comparable high-income countries.
It is also important that all parents who experience pregnancy and baby loss and need specialist psychological support can access it and can do so in a timely fashion. Too often, people who experience a psychiatric illness after their loss do not receive the support they need. I am proud that Labour supported this year’s Parental Bereavement (Leave and Pay) Act 2018. However, I know that many parents and caregivers entitled to bereavement support do not have access to appropriate mental health support. Right now, most mental health support is only available to mothers, and is focused on women who are pregnant or who already have a baby. This support often takes place in neonatal units, which understandably—as we heard earlier from the hon. Member for Brigg and Goole—can add to trauma.
Mental health support for those who have lost a baby must take place in appropriate places and must be available for the entire family unit including fathers, siblings, grandparents and so on. Coping with grief over the loss of a baby is something that all family members will need time and space for. Men and women may grieve differently, and it needs to be acknowledged that fathers can be forgotten in this experience, particularly as they may express less emotion, which can be misunderstood as indifference to the loss of their baby. Dad Keith has talked to the charity Tommy’s about the stillbirth of his second born, a son named Owen. He said:
“I had to go back to work straight away. It was a good distraction. I ran a lot and I kept doing that. I signed up for marathons. Running got me away for a few hours at a time and gave me a way to switch off. I wasn’t right for at least six months after. I was functioning but I was on autopilot. I wasn’t myself. People might not have noticed too much.”
I urge the Government to develop a national standard with guidance to support the planning, funding and delivery of specialist services with psychological support for those going through the loss of a baby. It is also important that bereavement-trained midwives or gynaecological counsellors are available in every hospital —not part-time, but full-time—whenever parents need them. Let us not forget that many stillbirths and neonatal deaths are sudden and unexpected. It is a hugely traumatic experience and people need support immediately, so trained individuals are so important.
I would like to end by saying a few words about the national bereavement care pathway. The final independent evaluation of the national bereavement care pathway wave of two pilot sites was published in May 2019 and provides evidence that the NBCP has improved bereavement care received by parents after the loss of a baby. It is commendable that both the former Prime Minister and the former Health Minister, the hon. Member for Thurrock (Jackie Doyle-Price), both endorsed the roll-out of the programme. The NBCP is increasingly attracting interest from NHS trusts across the country, and I hope that many more adopt this approach.
In conclusion, the debates that we have had over the past few years and again this evening underline the importance of the work undertaken by hon. Members and the many charities in this sector. It means that the silence that Members have spoken about today is now beginning to end. I cannot overstate how courageous those who have spoken out about their personal experiences are, or how influential those interventions are proving to be. I hope that those who have spoken out continue to have the courage to talk about what we need to do to improve care and support for bereaved families.
Women’s Mental Health
Paula Sherriff Excerpts(4 years, 6 months ago)
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Paula Sherriff (Dewsbury) (Lab)
I congratulate the hon. Member for Bath (Wera Hobhouse) on securing this important debate and thank all Members who have spoken in it. I also welcome the Under-Secretary of State for Health and Social Care, the hon. Member for Mid Bedfordshire (Ms Dorries), to her new role. I look forward to having some robust debates with her across the Dispatch Box in the weeks and months to come.
We have heard some excellent contributions this afternoon. The hon. Member for Bath discussed how important it is to consider trauma-informed services. She also talked about eating disorders, and I thank her for the excellent work that she has done in that area. My hon. Friend the Member for Southend West (Sir David Amess)—may I call him my hon. Friend?—spoke passionately about his constituents, Carla and Kelly. I have had the pleasure of meeting them, and I would like to applaud them for the wonderful work they do on endometriosis, which, as he knows, is a subject close to my heart. He also talked about prisons. I had the pleasure of visiting a local women’s prison on the edge of my constituency a few weeks ago, and it was incredibly interesting to talk to the women about their experiences there. It was striking to learn just how many of them had a history of mental health problems.
My hon. Friend the Member for Manchester, Withington (Jeff Smith) discussed how crucial it was that post-natal women were offered a six-week standard maternal check. My hon. Friend the Member for Lewisham West and Penge (Ellie Reeves) talked movingly about her own experience of pre-natal depression and how important it is that the mum’s mental health is considered at the post-natal check. We also heard from the hon. Member for East Worthing and Shoreham (Tim Loughton) about the importance of maternal mental health and about how crucial it is that early intervention is offered as soon as possible. That is something that the whole House can get behind, and I thank him for his contribution.
My right hon. Friend the Member for North Durham (Mr Jones) mentioned something that really resonated. He said that we must hard-wire mental health information into every public policy. Once again, I am sure that all of us in the House would agree with that. It is really good to see the former Minister, the hon. Member for Thurrock (Jackie Doyle-Price), here. I thank her for the excellent work that she did and for her collegiate and collaborative approach. She also made some excellent points today, particularly about the impact that sexual violence can have on people’s mental health.
Last but not least is the hon. Member for North Ayrshire and Arran (Patricia Gibson). Like others, she began by saying that mental health problems are nothing to be ashamed of. We cannot repeat that enough; it is incredibly important. Stigma does still exist, although some excellent work is being done to reduce it. Still, we must keep repeating this until people believe it.
We know that we face a mental health crisis, and women are certainly not exempt from it. Women are more likely than men to have a common mental health problem and twice as likely as men to be diagnosed with an anxiety disorder. That feeds through to service delivery. Women account for around two thirds of referrals to the improving access to psychological therapies programme. While some of this might come from different attitudes towards sharing mental health problems, it still speaks to an undeniable truth that we must prioritise women’s mental health. In particular, we must pay attention to the mental health of young women: while 20% of women overall have a common mental health problem, that figure rises to 28% of women aged between 16 and 24.
Mental health conditions do not arise in isolation. They are not inherent to a person and are not always unavoidable. Instead, they are bound up with the circumstances in which a person lives their life. They are also closely linked to the way we are treated by others. That is something that all of us in this place should consider carefully at a time when many of us in this Chamber, women in particular, have received death threats and other horrendous abuse.
Before I go on to mention two situations that might have a particular impact on the mental health of women, I want to mention the broader issues that affect our mental health. One of the consistently recognised causes of mental health problems is financial stress: whether it is struggling to find work or being trapped in a job that does not pay enough to make ends meet, this can be a source of enormous stress. As we have heard from a number of hon. Members, there is clearly a link between poverty, austerity, deprivation and mental health. That in turn leads to people developing mental health problems: 35% of women who are unemployed have a common mental health problem, compared with only 20% of women in full-time employment. We know that women are more likely to be unemployed or in lower-paid roles than men. Industries that rely largely on minimum wage workers on zero-hours contracts, such as social care, overwhelmingly employ women.
As well as being a cause of mental health problems, economic instability can open women up to abuse by others, whether that is their employer or a controlling partner. One woman in four will experience domestic violence. As well as the physical trauma of that abuse, survivors can be left with long-lasting mental health problems. Women who suffer domestic abuse are three times more likely to develop a mental illness, including severe mental illnesses such as schizophrenia and bipolar disorder.
Addressing that serious issue works two ways. We need to ensure that services for the survivor of domestic violence, whether the police, shelters or other organisations, are better at recognising mental health problems. Our mental health services need to get better at recognising the signs of domestic abuse. One way they can do that is to be more aware of the reasons a woman might not attend a follow-up appointment. Controlling and coercive partners can easily stop someone going out to attend a medical appointment. Mental health services should be awake to that possibility, and not simply move straight to discharging people.
We have an opportunity to address that through the Domestic Abuse Bill. This is a crucial Bill that, thankfully, has not been lost due to Prorogation. We should use the Bill to bring domestic violence and mental health services closer together so that fewer people are lost between the two. Like many colleagues, I pay tribute to the emotive speeches that were made yesterday from both sides of the House—in particular, the contribution from my hon. Friend the Member for Canterbury (Rosie Duffield). We can all agree that she was incredibly brave when she made her extraordinary contribution. We thank her for that. Will the Minister say what conversations she has had with her colleagues about joining up mental health and domestic violence services?
Unpaid family carers in the UK are more likely to be women, and therefore more likely to be providing round-the-clock care for the people they care for. Caring for a friend or family member can have a significant impact on a person’s own mental health. That is particularly true for women carers, who are more likely to be sandwich carers, caring for young children and elderly relatives at the same time.
A survey from Carers UK found that more than two thirds of carers have suffered poor mental health as a result of caring. Carers looking after children and young people, and those who have been caring for 15 years or more, are also more likely to have poorer mental health. Carers are being let down by this Government, and this is taking its toll on their mental health. One carer told the Carers UK survey:
“I was admitted to hospital after a breakdown due to exhaustion and chronic pain. If I had had more breaks from my caring role or adequate mental health support, I might not have had the breakdown at all.”
Access to adequate support and carers’ breaks are crucial to ensuring carers do not reach crisis point. Carers’ breaks are particularly important for mental health, as nearly half of carers have used their breaks to attend their own medical appointments. The Government’s failure to set out plans to support carers properly, or address the crisis in social care, is taking its toll on the mental health of unpaid carers. We have had a watered-down action plan that promises very little action to support carers. It is time for a full national carers strategy that sets out plans to ensure carers have adequate support, including with their mental health. So will the Minister outline how her Department intends to ensure that carers have access to the support they need? Furthermore, will she commit to increasing access to carers’ breaks?
All of this has caused a mental health crisis among women. As I have mentioned, women are far more likely to be referred for basic therapy than men, reflecting both the prevalence of mental health conditions and a willingness to seek help. But a referral to these services is not a guarantee that someone will get the help they need. Talking therapies through IAPT still have a noticeably higher recovery rate for white women than they do for black and minority ethnic women. They also are not working for young women. A 16 or 17-year-old woman accessing IAPT services has a lower chance of recovery than a woman of any other age—or than a man in any age group. We have to do better than this. It simply is not acceptable that someone’s chances of recovering on the primary NHS care pathway for mental health is so dependent on their age, gender and ethnicity.
I wish to take this brief opportunity to thank some of the peer support groups in my constituency, which work so incredibly hard, particularly for those who struggle to access traditional NHS services. Stevie Morley from Take Ten offers the most phenomenal service for those who are suffering from mental health problems, and I wish to use this opportunity today to thank her. I also wish to thank Auntie Pam’s, which is based in Dewsbury and supports young mums, expectant mums and those who are just having problems, perhaps even problems conceiving. Auntie Pam’s is made up of local young mums and they are just wonderful.
The current situation is why Labour will ask the National Institute for Health and Care Excellence to carry out a full review of the psychological therapies available on the NHS, to ensure that everyone is able to access therapies that are appropriate and work for them. For some people with a mental health condition, it may be necessary to go beyond talking therapies or community support. When that is the case, we should be working to ensure they receive the best treatment possible. But too many women are still being mistreated in mental health units. Last year, more than 4,000 women held under the Mental Health Act were subject to restriction. Each woman was subject to an average of 12 restrictive interventions, which is far more than for the average man.
One example of how this excessive restriction can look in practice is seen in the case of a woman called Alexis Quinn. Alexis is an autistic woman who has spent years of her life trapped in a mental health unit. Since she escaped this unit she has shared her experience, and it is truly harrowing. After she tried to leave the unit, which she was on as a voluntary patient, she was held down and forcibly sedated. When she complained, she was locked in seclusion for more than a week. Alexis was restrained 97 times and secluded 17 times, although there were numerous seclusions which went unrecorded. When somebody seeks support from mental health services, they deserve better than that. It can never be right that we fall back on violent restraint and seclusion.
There is a crisis in mental health support for women. Today’s debate has called for more mental health support tailored specifically to women. Members have called for greater access to mental health support for domestic abuse victims, and greater support for young women and girls and for carers.
In conclusion, we need urgent investment in mental health. Our mental health services should be comprehensive and universal, and we need to invest in early intervention as a priority. Women should be able to access specialist, gender-specific, in-patient and community services that recognise the traumatic nature of domestic violence or abuse. Women experiencing a mental health crisis must be treated with dignity and respect, but too often this is not the case. On all these areas, the Government are simply not doing enough. Women deserve better than being ignored or fobbed off with services that do not work. It is time to act and deliver a mental health system that truly delivers for everyone.
Body Image and Mental Health
Paula Sherriff Excerpts(4 years, 9 months ago)
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Paula Sherriff (Dewsbury) (Lab)
Let me start by welcoming the Minister to the Front Bench. I am glad that she is still in her post, and I sincerely hope that this is not her last appearance at the Dispatch Box in her current role. She has been collegial, engaging and very co-operative, and I thank her for her kind words about eating disorders. I agree with most of what she has said this afternoon.
“Body image” is the term that is used to describe the way we think and feel about our bodies, which can have an impact on us throughout our lives and cause poor mental health and a lack of wellbeing. While the association between body image concerns and poor mental health is definitely not new—we have been discussing it for decades, and I am sure that we will still be discussing it for decades to come—I think it is fair to say that the problem is worse now than it was just 10 years ago. There is a far greater exposure to the media and to social media, and there is also our need to have everything, right here and right now, in the impatient and judgmental world in which we live. As the Minister said a few moments ago, we still have a long way to go in tackling this issue. Would it not be great if we recognised that, literally, one size does not fit all?
Body image concerns are extremely common, and vary in severity. Not all body image issues will affect mental health. However, it is important to be aware of the risk factor, especially among young people, as the risk of developing an eating disorder is closely associated with poor body image. The Mental Health Foundation has undertaken a great deal of research in this area, and recently conducted a survey of 4,505 UK adults aged 18 and above and 1,118 UK teenagers aged between 13 and 19. The results showed that one in five adults felt shame about their body image, 34% felt down or low, and 19% said that they had felt disgusted because of their body image in the last year, with 13% saying, very worryingly, that they had experienced suicidal thoughts and feelings. The survey of teenagers revealed that 37% felt upset and 31% felt ashamed in relation to their body image.
Perhaps more worrying are the results from Be Real’s Somebody Like Me campaign. The researchers spoke to more than 2,000 secondary school pupils aged 11 to 16 from across the UK, and found that 52% regularly worried about how they looked, 30% isolated themselves because of body image anxiety, and 36% said that they would do “whatever it takes” to look good, including considering cosmetic surgery. Similarly, 10% of boys surveyed by the Mental Health Foundation said that they would consider taking steroids to achieve their goals.
As the Minister said earlier, we must recognise that body image challenges affect boys as well as girls, and men as well as women. Unfortunately, my hon. Friend the Member for Islwyn (Chris Evans) is not present, but he has previously spoken powerfully about the body image challenges that he faced as a younger man, and I think that he is a great ambassador for this issue.
It is a shame that more Members on both sides of the House are not present for such an important debate. I understand the significance of today and the fact that other things are obviously going on, but for the benefit of those who are watching in the Public Gallery and others who may be watching at home, I want to reiterate my support, and that of the Minister and other Members in relation to this issue.
The shocking statistics that I have cited highlight the need for more support and help. Perhaps most worrying is the finding that a desire for the option of cosmetic surgery appears to be more and more widespread. I welcome what the Minister said about the need for stronger regulation, because cosmetic surgery has almost become normalised. Many of my friends have lip fillers and Botox treatments. I have not succumbed to either as yet, but people are now moving away from breast augmentation and talking of “bum lifts” and “Brazilian bums”.
A young and beautiful lady from a constituency not a million miles from mine, in Leeds, went to Turkey—last year, I believe—to undergo one of those procedures, which involves the injection of fat into the bum. I am not sure whether that is parliamentary language, Madam Deputy Speaker. She was a mum of three beautiful boys, and she never came home. She died during the procedure. I understand that inquiries may well be pending in that case, but it is very worrying that people are going overseas to seek cheaper treatments when there may be issues relating to, for instance, regulation.
Given mainstream television programmes such as “Love Island”, which shows girls as young as 21 who have already undergone plastic and cosmetic surgery, it is hardly surprising that those who watch such programmes aspire to the same treatments. The same applies to tanning salons. In those reality programmes, everyone is bronzed and slim, and the people watching think, “I want to go to one of those.” It is very worrying, partly because some of the less scrupulous tanning salons do not necessarily follow the regulations that are so important to avoiding skin cancer.
It has been widely accepted in many different body image studies that those who are most at risk of developing mental health problems associated with poor body image are women and members of the LGBT community, but, as has already been pointed out today, that does not mean that we should dismiss the incidence of such problems among other groups, although they are not as prevalent. There is no group of people who have not been identified as having certain risk factors or anxieties associated with how they view their body image.
Airbrushed photos have appeared for decades in the media, from the early glossy magazines such as “Just 17” in the 1980s to the internet today. Throughout the internet, images are portrayed that invade people’s lives daily. Indeed, when undertaking research on this subject, I found that the search results on the internet were not giving information about the history of airbrushing, but were offering tips and trying to sell software enabling people to airbrush their own photographs. It should come as no surprise that the increased number of airbrushed images across the internet that are accessible to millions of young people has played a part in the huge increase in the number of people suffering from body-image anxieties in recent years.
During the Minister’s speech, my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) and I were looking at an internet picture of Serena Williams, the famous and phenomenal tennis player. She recently appeared on the front page of “Harper’s Bazaar”, and had specified that she did not want the images to be airbrushed. I should add that those images were themselves phenomenal. It was a great lesson, and I hope that other celebrities will consider doing the same. Some have had their pictures taken make-up free, which is also a great thing to do.
We have also seen an increase in the number of television programmes that heavily promote the idea of a “perfect body type”. As I said earlier, “Love Island” is probably the most topical and talked-about programme of the moment. It focuses primarily on young men and women, all of whom can only be described as nothing less than beautiful. Even the show’s host allegedly admitted in 2017 that it portrayed unrealistic body image standards, and, at the start of the current season, Twitter was alight with comments from viewers about how inadequate the contestants were making them feel. I understand that a “plus size” person has featured in the programme this year. I have to say that I have never watched it—my research evidence comes from the internet, and from friends and, dare I say, staff members who do watch it—but I understand that the producers’ concept of “plus size” may not be the same as ours.
I love to read glossy magazines—many of us do when we get the time—and sometimes looking at the models I do think, as somebody who would love to lose a bit of weight, “Crikey, could they even put in someone who is average-sized?” The average UK female dress size is 16, and some of these models, frankly, look unhealthy.
I want to share a story. I went to a big department store in London just before Christmas last year, and I asked for a dress that was out on the rail in a concession in the store. The size I wanted was not available and the lady working there said to me, “Oh, I’ll have a look in the back for you, as that doesn’t mean we haven’t got it; we just only display sizes eight, 10 and 12.” There is so much that we can do working with the corporate world as well to change these attitudes, and it is very important. We cannot overestimate the impact of little things like not displaying bigger sizes because the designers do not want that look.
“Love Island” is far from the only culprit in the world of television. In recent years there have been many programmes, including “The Only Way is Essex”, “Geordie Shore” and “Made in Chelsea”, that seem to focus on what for many is an unattainable body type. It is almost an oxymoron to call them reality shows when in actual fact they do not portray the reality of the way the average person looks.
The TV programme “Loose Women” has to be applauded for its body confidence campaign last year. It is easy to think that people in later life do not suffer from body image anxieties, but a Mental Health Foundation study found the contrary: approximately 20% of adults aged 55 or over admitted to feeling anxious or depressed specifically because of their body image. Campaigns such as this are incredibly important in helping to show people that their anxieties are shared by many. Indeed, a friend of mine will often say that everyone is too busy worrying about how they look themselves to ever notice how someone else looks, and I do wonder how much truth there is in that.
Sadly, however, that does not appear to be true of how people in the public eye are judged. Body-shaming and trolling of celebrities are prevalent in the media and are on the increase. When Gemma Collins took to our screens last year as a contestant in “Dancing on Ice” she received the most appalling treatment from not only the public but also, disappointingly, one of the judges, most of it based solely on how she looked.
Sadly, it almost appears to be acceptable in today’s times for those we unaffectionately term “keyboard warriors” to hound and troll people who are well known. As politicians, we all, sadly, suffer abuse on social media too, and I am certainly not immune from that. Reference is often made to the fact that I am overweight, by saying, for instance, “You fat cow.” That is absolutely unacceptable, as it also would be if the trolls were referring to somebody as too thin. It saddens me greatly to see that.
All too often the social media companies are turning a blind eye and refusing to take action over comments that are ruining lives. I am sure we will all at some point have received a message after reporting a post on social media saying, “It does not contravene our rules and regulations.” Indeed, I reported something to Facebook a couple of weeks ago and the reply was, “It does not contravene our community standards,” which raises the question of what on earth its community standards are. The term “standards” here is an oxymoron, perhaps. I have often wondered how far someone would have to go before these companies took any action. A Mental Health Foundation study found that 22% of adults and 40% of teenagers said that images on social media cause them to worry about their body image. Personally, I would like to see much more regulation around social media and much more robust complaint mechanisms that make reporting easier, with more complaints upheld and firm action taken.
It is no coincidence that an increase in social media use is accompanied by an increase in body image issues, which in turn is accompanied by low self-esteem and poor mental health. While I appreciate that social media also has many positive aspects, we must ensure that these are not outweighed by the negatives. As parliamentarians, we all have a duty to do whatever we can to hold social media companies, TV producers, advertisers, magazines and individuals to account where they are seen to be promoting negative or unachievable body images. We also have a duty to ensure that the correct help is available so that everyone, specifically our young people, are able to use vital services and support to help combat the growing link between body image and poor mental health.
Oral Answers to Questions
Paula Sherriff Excerpts(4 years, 9 months ago)
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Jackie Doyle-Price
As usual, the hon. Gentleman raises an extremely important point. Of course, health is a devolved matter, but that is not to say that all four nations cannot learn more from best practice in each place. I am pleased to say that we are now increasing our contact with representatives of the devolved Governments, and we will very much be sharing such best practice.
Paula Sherriff (Dewsbury) (Lab)
Referrals to child mental health units from primary schools for pupils aged 11 and under have risen by nearly 50% in three years. BBC research last week also found that primary school children are self-harming at school, and in four cases children under 11 had attempted suicide while at school. This is deeply shocking, so what is the Minister doing to ensure that primary school children will have support from trained mental health professionals when they return in September?
Jackie Doyle-Price
The hon. Lady is quite right to raise that, and it is incredibly troubling to see those figures. The investment we are making in mental health support teams will be of assistance. For primary schools that are well led and gripping this issue, there is some very imaginative and innovative practice to bring emotional wellbeing into the classroom from the moment pupils arrive. We need to make sure that those mental health teams start acting as soon as possible. This is something that we need to address collectively with schools and as a society to make sure that we get treatment to people at the earliest possible time.
Non-invasive Precision Cancer Therapies
Paula Sherriff Excerpts(4 years, 9 months ago)
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Paula Sherriff (Dewsbury) (Lab)
I thank the hon. Member for Westmorland and Lonsdale (Tim Farron) and my hon. Friend the Member for Easington (Grahame Morris) for securing this debate and the Backbench Business Committee for allowing the time for it.
As my hon. Friend the Member for Blackburn (Kate Hollern) said so poignantly this afternoon, cancer is a disease that touches us all. In my case, it was my lovely dad who was diagnosed with bowel cancer in his 50s. Thankfully, due to early diagnosis and amazing NHS expertise, he survived. I am truly blessed that he is still with us. However, not everyone is that lucky.
I also pay tribute to my hon. Friend the Member for Rhondda (Chris Bryant), who, with his typical fortitude, eloquence and courage, spoke about how important it is that people seek all-important help upon noticing symptoms.
Of those of us born in the UK after 1960, almost half of us will be diagnosed with cancer at some point in our lifetime, and around a quarter of us will receive some form of radiotherapy. These are scary statistics. Radiotherapy is not some obscure treatment that is easy to ignore because it only happens to someone else. Statistically, every fourth person in this room will have had or will at some point need radiotherapy. If nothing else, from a purely self-preservation perspective, it is in all our interests to ensure that the provision of radiotherapy is exemplary.
Although the UK has a long history of being active in radiotherapy research due to having a much higher radiotherapy machine capacity and a larger workforce than elsewhere, access to radiotherapy in many parts of northern Europe is now superior to that in the UK. Radiotherapy need in the UK is expected to rise by a further 25% by 2025, but as things stand and as has been demonstrated today, the provision of radiotherapy across the country is patchy at best. Indeed, it is widely held by the experts that up to 24,000 people may be missing out on the radiotherapy they need, resulting in thousands of unnecessary or premature deaths each year. This is simply not good enough.
The advanced radiotherapy techniques of today are the standard techniques of tomorrow, and we need to invest in ensuring that these treatments are easily accessible for all patients across the country as soon as possible. There have been major breakthroughs in radiotherapy in the last 10 years. Technological advances have made radiotherapy treatments safer and more effective, improving cure rates with fewer short and long-term side effects—often to the point where patients can even continue working during the course of their treatments.
Advanced radiotherapy is now an extremely effective treatment in curing cancer when the disease is detected early enough and for palliating symptoms when a cancer has spread. However, this advanced radiotherapy is not currently available across all the UK, with many advanced radiotherapy techniques available at only a small number of centres, as the hon. Member for Westmorland and Lonsdale pointed out.
Radiotherapy centres across the UK are unevenly distributed, and although it is estimated that radiotherapy is needed to treat more than half of all diagnoses of cancer, access to it in England varies between 25% and 49% of cases, depending on the region. The charity Action Radiotherapy reports that patients understandably want to be able to access the best-quality radiotherapy as close to home as possible. Only 57% of the people surveyed said that they would be willing to travel as far as was necessary to get the best radiotherapy treatment available, with many opting for shorter travel times and convenience over quality. It is vital, therefore, that we ensure that the best possible treatment is available consistently across the UK, so that every patient is able to access the best high-quality radiotherapy for their individual cancer, without needing to worry about the added stress and inconvenience of lengthy travel times and distances and the associated costs.
However, tackling barriers to access is not only about travel and distance. Having radiotherapy can be very tiring, so greater consideration needs to be given to the quality of support that people receive throughout their treatment—for example, the provision of free parking and accommodation where needed or allowing people to book all their appointments in advance. Different types of radiotherapy techniques are not always available in the UK centres that are willing and able to deliver those treatments, and evidence suggests that some patients are missing out due to a failure of appropriate commissioning of the specific therapies they require.
One story I have heard about is Robert’s. When examining the surgery versus radiotherapy option, Robert was offered the opportunity to take part in a trial that explored whether, by using stereotactic ablative radiotherapy, or SABR—a type of non-invasive therapy—the number of radiotherapy treatments he would receive could be condensed to just five sessions, as opposed to the 20 currently recommended. For obvious and understandable reasons, the chance to have a short course of radiotherapy treatment appealed to Robert, and he underwent five sessions in just one week. It is disappointing, then, that such advanced techniques are available at only a small number of centres, reducing patient access.
As the cross-party “manifesto for Radiotherapy” outlined, £100 million a year is needed to catch up and provide the advanced modern radiotherapy currently needed in the UK. A one-off £250 million would be required to secure equal access for all radiotherapy patients over the next 10 years, with cutting-edge technology. Unfortunately, the commitment that we have from the Government thus far falls far short. As we have heard this afternoon, current spending levels on radiotherapy fall well short of our comparable international partners, and UK cancer survival rates lag behind the European average for nine out of 10 cancers.
As we have heard from my hon. Friends the Members for Heywood and Middleton (Liz McInnes) and for Rhondda and the hon. Member for Chichester (Gillian Keegan), a further clear and pressing concern is that our current oncology workforce is simply not large enough to meet current demand. There are inadequate plans to increase the workforce to ensure that it will have the capacity for our future needs.
Without drastic and immediate action to remedy the chronic, NHS-wide staffing crisis, we are in no position to deliver the improved radiotherapy treatments that we both deserve and have been promised. Per head of population, the NHS now ranks among the lowest in the western world when it comes to the number of doctors, nurses and hospital beds, according to King’s Fund analysis of OECD health data. Analysis from the Health Foundation showed that the number of personnel leaving the NHS because of a poor work-life balance has trebled in the last seven years.
The NHS workforce remains overstretched, overworked and undervalued. Much like the rest of our NHS, our radiotherapy services and staff need transformative actions, not words, to provide the world-class care that patients deserve. To address that, we would like a national plan for the funding of radiotherapy equipment, to enable every patient to have access to the appropriate treatment. Funding models should act to support innovation and research and should incentivise new and novel ways of working, but the current tariff funding of radiotherapy per fraction is clearly not fit for purpose. It can disincentivise novel ways of working, such as delivering a smaller number of fractions with a more complex technique.
As I said at the start of my speech, as many as 24,000 people are not receiving the radiotherapy they need. That cannot be allowed to continue. We must do more, today, to ensure that all those who need it are able to access not only radiotherapy but the best, high-quality radiotherapy available for their specific cancer. With sufficient investment and development, the UK can develop a world-class, patient-first radiotherapy service. I will do all I can to ensure that we achieve that goal.
Oral Answers to Questions
Paula Sherriff Excerpts(4 years, 10 months ago)
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Jackie Doyle-Price
The hon. Lady articulates the issue extremely well. The purpose of local suicide prevention plans is very much to make sure that we have a joined-up approach to combating male suicide and to identify exactly where the gaps in the services are. The £600,000 that we announced yesterday for the sector-led improvement package is to enable local authorities to share expertise and to make sure that, holistically, they provide the leadership to make sure that the gaps are plugged. I am grateful for the hon. Lady’s interest in this matter.
Paula Sherriff (Dewsbury) (Lab)
This week, the Children’s Society published research to show that more than 110,000 children and young people were turned away from mental health services because their problems were not deemed serious enough—that is despite suicide rates for teenagers almost doubling in eight years and research from YoungMinds that shows that three quarters of parents feel their child’s mental health has deteriorated while they wait for treatment. Why are so few children able to get the support from mental health services that they so desperately need?
Jackie Doyle-Price
As the hon. Lady and I have discussed previously, I would be the first person to recognise that we are not where we would like to be in respect of the provision of mental health services, but that is why we are investing an additional £2.3 billion to expand access for children by 345,000. In addition to that, we are investing in a brand new workforce in all our schools so that we can have exactly the kind of early intervention that will not require more lengthy periods of care and treatment. It is essential that we equip all schools and young people with tools to manage their wellbeing.
Interim NHS People Plan
Paula Sherriff Excerpts(4 years, 10 months ago)
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Stephen Hammond
The House will have listened to the hon. Gentleman. It is important to put out some facts, which were missing from his fact-free analysis. For example, we have had 52,000 more professionally qualified clinical staff in the last nine years, almost 16,500 more doctors and over 17,000 more nurses on our wards. He set out a list of promises, but with little detail and no means to pay for them. He asked a number of questions, which I will respond to.
The hon. Gentleman talked about the number of nurses and said that there was no plan. There clearly is. Increasing nursing is a priority, and this plan sets out—[Interruption.] If the hon. Member for Dewsbury (Paula Sherriff) would like to listen, this plan sets out a focus to ensure that we can recruit nurses. The hon. Gentleman talked about applications, but he will know that applications for nursing places are up 4% on the previous year. He will also know that the plan sets out 5,000 more clinical placements available in September this year, which is a 25% increase on the previous year. He will know that the plan sets out 7,500 more nursing associates. The plan also quite clearly sets out measures that will ensure that the NHS is the best place to work, and therefore more nurses will want to stay in it.
The hon. Gentleman spoke about a number of other issues. The Migration Advisory Committee has made recommendations, which he will have seen. He will know that the Secretary of State has made a firm commitment that we intend to continue to recruit internationally, as well as increasing domestic recruitment. He mentioned continuing professional development. It would be useful if he had read the plan, which sets out commitments to ensure continuing education and opportunities for education for all staff in the NHS. He will have seen that there will be a final level of commitment.
The hon. Gentleman speculates about the spending review. He speculates about a number of things, but it would be better not to speculate. It would also be better not to make allegations about my right hon. Friend the Secretary of State, who was doing his day job yesterday. I know that the hon. Gentleman is always interested in soundbites, and one soundbite he should have taken notice of was when my right hon. Friend said yesterday:
“the NHS is not on the table in any trade talks. The NHS is not a bargaining chip in negotiations, with the US or otherwise.”
Stephen Hammond
Perhaps that is the soundbite that the hon. Gentleman and his colleagues—including the hon. Member for Dewsbury, who is shouting across the Chamber yet again—should remember.
Acquired Brain Injury
Paula Sherriff Excerpts(4 years, 11 months ago)
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Chris Bryant (Rhondda) (Lab)
I beg to move,
That this House notes the report of the All Party Parliamentary Group on acquired brain injury and supports its conclusions; and urges the Government to work through all of its departments to ensure that those who have sustained brain injuries are guaranteed full neuro-rehabilitation as needed.
I rise to speak in support of the motion in my name and those of my hon. Friends, including those on the other side of the House—I see the right hon. Member for South Holland and The Deepings (Sir John Hayes) taking his place now.
Sometimes a brain injury is really obvious—jagged bone where the skull has been fractured or penetrated—but often the sheer force of the soft tissue colliding at speed against the hard inside of the skull bruises the brain, leading to a contusion or a haemorrhage that is outwardly invisible. Likewise, blunt trauma, where the head smashes into a windscreen or the road, means that the brain is pulled away from the opposite side of the skull, leading to even worse damage. The same can happen on the rugby, football, or hockey field, in the boxing ring and on the racecourse. Repeated incidents, even minor ones, can lead to chronic traumatic encephalopathy or what is often known as “punch drunk syndrome”.
Injuries can also be caused by stroke, tumours, infection, carbon monoxide exposure and hypoxia—oxygen starvation. These are hidden injuries with complex and fluctuating life-changing effects that strike close to the heart of what it is to be human, to be conscious, to be alive and, in many cases, to want to be alive.
Paula Sherriff (Dewsbury) (Lab)
I am sorry that I cannot stay for the whole debate but, prompted by my hon. Friend’s excellent work in this area, I recently visited the Second Chance Headway Centre in Wakefield, which supports people with brain injuries. I was struck by the spectrum of conditions that the centre deals with and by the dedication of its wonderful staff and volunteers. I encourage all Members to visit a Headway centre in their constituency, and I want to make the House aware that it operates a free helpline, which is driven by nurses, that people can call for advice.
Chris Bryant
My hon. Friend is absolutely right. I know that many Members in the Chamber today and others, including Ministers who are unable to participate in the debate due to their ministerial responsibilities, have also visited Headway groups in their constituencies. I have been to the group in Cardiff, which does a magnificent job. This is also about those who work in the NHS and alongside many of the voluntary organisations that do magnificent work. For many people, the work is thoroughly rewarding, because somebody can be taken from complete dependency on others to needing much less frequent support through neuro-rehabilitation, enabling them to stand on their own two feet and have the quality of life that they had before.
Chris Bryant
That specific point has not been raised with me in relation to brain injury because it is one of the seeable bits. It is the unseeable bits that are particularly difficult for PIP assessors and other assessors to get right, which is why it is important that they all have proper experience and training in assessing brain injury.
I do not want to take too much time because I know that many others want to speak, but I will refer to a few more elements, the first of which is the prisons system. All the latest research shows that a very high percentage of inmates, both male and female, have had a brain injury. One survey shows that 47% of inmates at Leeds Prison have had an ABI, and Huw Williams’s work shows that more than 60% of prisoners at Exeter Prison have had a traumatic brain injury. In both surveys, the majority of injuries occurred before the prisoner’s first offence, suggesting that the brain injury may be a key factor in why they offended in the first place. If we really want to tackle their reoffending, we will have to deal with their brain injury, too.
Research at HMP Send and HMP Drake Hall also finds that the most common way for women inmates to acquire brain injuries is through domestic violence— 45% of injuries. Again, we may be criminalising people who are actually victims. We need to get this right. If we really want to tackle reoffending, we must do a better job of recognising and treating brain injury. That means screening all new prisoners, training prison staff, providing proper neuro-rehabilitation for all prisoners with a brain injury and making special provision for women that recognises the likely different causes of their injury—particularly domestic violence.
I will not say much about education, because I know other hon. Members will. The Government have been good in responding to our report in detail, but the section of their response with which I am most dissatisfied is on education. There is a hidden problem across our schools estate, and we will store up problems for the future if we do not take this issue seriously. In particular, I urge the Government to reconsider our recommendation that acquired brain injury should be included in the special educational needs and disability code of practice.
The final area is sport. I make it clear that sport is good for people’s health, and I do not want to prevent anyone from taking part in sport. I do not want all our sportspeople and youngsters to be mollycoddled and wrapped in cotton wool, but the record on sports concussion is shockingly bad, particularly in football. I am no football expert.
Chris Bryant
All right. I am no expert, but I know about concussion in football. The last season has been especially bad. Mohamed Salah, Jan Vertonghen, David Ospina, Anthony Lopes and Fabian Schär have all been involved in high-profile, very dubious decisions by the on-pitch medics. UEFA rules since 2014 seem clear:
“In the event of suspected concussion, the referee stops the game to allow the injured player to be assessed by the team doctor. In principle this should take no more than three minutes, unless a serious incident requires the player to be treated on the field of play or immobilised on the field for immediate transfer to hospital”.
Honestly, three minutes is nowhere near enough to be able to judge whether somebody has suffered a concussion or any other kind of brain injury. Moreover, FIFA, UEFA and the Football Association have different definitions of concussion and, unlike rugby—where it is now standard that a player should be off the pitch for 10 minutes and can be replaced—football allows no subs for concussion, so all the incentive is to get the player back on and playing as fast as possible and in less than three minutes.
Let me be very clear to the football authorities. Football is failing its players. It is giving a terrible message to youngsters, parents and amateur coaches. Those authorities are putting players’ lives at risk. If they do not get their house in order, they will face massive class actions in the courts and we will have to legislate to protect players from what is, frankly, an industrial injury.
I want to end by talking about my own patch. I am delighted that south Wales will soon have a new major trauma centre at the University Hospital of Wales, but it would be cruel in the extreme to save people’s lives without ensuring that we can guarantee their quality of life. So we must make sure that when the centre opens there are proper neuro-rehabilitation services in Wales and that there is continuity of care once people leave hospital.
There is another issue for us in south Wales. In 2009, Kyle Beere was a typical healthy, intelligent, active 12-year-old—a bit too interested in fishing for my liking, but none the less. That November, he suffered a massive brain haemorrhage that left him fighting for his life. With no paediatric rehabilitation service in Wales, Kyle had to travel to Surrey for treatment. He is grateful for his treatment and his family is working all God’s hours to ensure that he gets all the support he needs. But I would dearly love there to be paediatric rehabilitation services in Wales.
Many medical miracles have been performed over the years, and I pay tribute to the doctors, nurses, scientists, pharmaceutical companies and staff who have constantly experimented and reviewed their work to see whether they can do more. I pay tribute to Chloe Hayward and everybody involved in the UK Acquired Brain Injury Forum. But we need a political miracle now.
The Health Committee produced a great report in 2001, but many of its recommendations have never been implemented. That cannot happen this time—please. We need a champion in Government to instil a real sense of urgency into dealing with brain injury: someone who can bring together all the different Departments and make them work together to deliver a quality of life that is more than just a collection of vital functions. I dearly hope that that champion will be speaking from the Dispatch Box in a few minutes.