Oral Answers to Questions

Paula Sherriff Excerpts

Tuesday 7th May 2019 Commons Chamber

[Jackie Doyle-Price]

The right hon. Gentleman will be aware that we expect all local communities to have suicide prevention plans, part of which will be that they engage in areas of greatest risk, whether it be regarding place or their populations. Suicide is the biggest killer of young people and I expect local authorities to engage with education providers to make sure that sufficient measures are in place. We are in the process of challenging the plans to make sure they are fit for purpose.

[Paula Sherriff (Dewsbury) (Lab)]

Universities UK has warned that it simply cannot keep expanding to fill the gaps left by inadequate funding for NHS services, after university spending on mental health services rose by almost half in five years. Too often other sectors such as education are left to fill the funding gap this Government have left in mental health, so can the Minister tell me today when her Government will match our pledge to ring-fence funding for mental health?

[Jackie Doyle-Price]

I have always viewed the ring fence as a ceiling rather than a protection. We have the mental health investment standard and NHS England is challenging clinical commissioning groups that are not spending what we would expect.

This is a systemic weakness. We have treated children up to 18 and then considered them as adults, but the reality is that people do not suddenly achieve majority overnight. We intend through the forward plan to have the children and young people service from nought to 25. That should enable transition and stop people falling off the cliff edge at 18.

Government Mandate for the NHS

Paula Sherriff Excerpts

Thursday 25th April 2019 Commons Chamber

[Stephen Hammond]

Anyone listening to that will have realised that the hon. Gentleman is more concerned with political points scoring and process than with the substance and funding of the NHS. [Interruption.] The hon. Member for Dewsbury (Paula Sherriff) shouts at me, but she will want to remember that the shadow Secretary of State welcomed the long-term plan—or much of it—back in January.

It is absolutely clear—evidence was provided to the Public Accounts Select Committee yesterday by the permanent secretary and the chief executive of NHS England—that while obviously it would be better to publish by the deadline, it is more important that the mandate be right than published on a particular day. It is more important that we get this document on the long-term strategy of the NHS correct. As Simon Stevens, the chief executive of the NHS, said, there is no problem with this short delay to the mandate. It is an important document, but it is causing him no problems. It is causing no problems.

The hon. Gentleman mentioned access to treatment and treatment times. This winter, more than 7 million patients were seen in under four hours. That is an increase of nearly 6% in attendances. I would have hoped that the Opposition Front Bench might have praised the NHS and its hard-working staff—

[Paula Sherriff (Dewsbury) (Lab)]

Always do. I worked in it for 17 years.

[Stephen Hammond]

Rather than shouting political points across the Dispatch Box.

The hon. Gentleman says there are no targets. He is of course wrong.

--- Later in debate ---

[Stephen Hammond]

The hon. Lady does a great injustice to my right hon. Friend. He is today—

[Paula Sherriff]

Writing his speech for the leadership!

[Stephen Hammond]

In the hon. Lady’s fantasy world, that may be true, but my right hon. Friend is in fact addressing a conference in Manchester, talking about the gender pay gap and how this side will close it in the NHS. I would have thought she would welcome that, rather than shouting at me.

Hormone Pregnancy Tests

Paula Sherriff Excerpts

Tuesday 23rd April 2019 Westminster Hall

[Paula Sherriff (Dewsbury) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. Like other hon. Members, I sincerely thank my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for securing this debate. I also thank Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests. Without those two strong, brave women and their pursuit of justice, truth and answers, we would probably not be having this debate. I think we can all agree that the personal stories that we have heard today are very powerful indeed, and that these people and their families deserve definitive answers to their questions, especially after so many years.

Although I am pleased that the Government have committed to the ongoing review, I hope that on this occasion all available data will be analysed and all research will be taken into account, so that the review’s conclusion can satisfy those who have campaigned so vociferously for so many years. It is alarming to read the report from experts at Oxford University, led by Carl Heneghan, Professor of Evidence-Based Medicine. The report appears to identify huge gaps in the expert working group’s 2017 study.

To find that huge areas of research were left untouched is nothing short of an insult to the campaigners who have devoted their lives to seeking justice. Some reports suggest that key elements of research were removed on purpose to support the conclusion and mislead Government and Parliament. If so, we as parliamentarians must do our utmost to right those wrongs; I hope that today the Minister will pledge to do just that. Indeed, the Prime Minister herself said in January that she would

“listen very carefully to any recommendations that come out of the review”.—[Official Report, 16 January 2019; Vol. 652, c. 1160.]

The results of animal testing from a 1979 study released by the pharmaceutical manufacturer Schering, now owned by Bayer, found strong links between the drugs and malformations, as well as the death of embryos, and yet the expert working group in 2017 declared that those results provided insufficient evidence. The expert working group examined human studies, and the majority similarly favoured an association between Primodos and deformity, but still the working group felt that the evidence was not strong enough. Was the evidence not properly assessed, or was it simply omitted? Either way, that conclusion has undoubtedly prolonged the agony of those who have lived for 50 years without answers.

There has been much talk about whether meta-analysis should have been used by the expert working group in 2017. When Professor Heneghan carried out a random-effects meta-analysis, the results were opposite to that of the expert working group report and found that there was an association between the drug and the malformations, which was consistent with his own study.

[Sir Edward Davey]

I think I am right in saying that when the raw data that the expert working group had used was rerun by Professor Heneghan, it showed that if the expert working group had done that, it would have reached similar conclusions. That makes the group’s conclusions even more worrying.

[Paula Sherriff]

The right hon. Gentleman makes a very important point, which gives further credibility to the view that the review by the expert working group was completely insufficient.

One thing that I have been utterly appalled about during my research on this subject is the inhumane and patronising way in which women were treated and spoken about during the period that Primodos and other hormone pregnancy tests were available, and subsequently, when a possible link between the drugs, early abortions and birth defects was identified. As the chair and founder of the APPG on women’s health, I am often asked why I feel it necessary to have a group that looks exclusively at women’s health. This is a prime example of the inequality that women have faced over the years when they have sought help on major health issues.

One senior medical officer from the Committee on Safety of Medicines said in 1969:

“It is somewhat difficult to summon up enough enthusiasm to place a high priority on this, when so much other and possibly more important work is pressing.”

In 1968, Dr N.M.B. Dean, of the Royal College of General Practitioners, stated:

“With regard to the rather high incidence of abortions in the Primodos group, I think it must be borne in mind that women going to their doctor for this type of test often hope that they are not pregnant and it is not impossible that these women took other steps to terminate their pregnancies”.

[Emma Reynolds]

Those quotes are breathtakingly horrific. My constituent gave birth in the late 1960s to Steven, who had severe abnormalities thanks to Primodos, and she then went on to conceive two healthy daughters. My constituent wanted to be pregnant, and she wanted a family.

[Paula Sherriff]

My hon. Friend makes an excellent point. Time has not been a healer in this case. We need to understand what has happened and we need to get answers for the affected groups.

The quote from Dr Dean goes on:

“In view of these findings tentative though they are, it would be my own view that, since there is in any event no very sound medical reason (in my opinion) for the use of such hormonal preparations, Primodos should be withdrawn from use.”

To suggest that women going through the pain of dealing with a miscarriage had perhaps taken steps to terminate their pregnancies is nothing short of abhorrent, especially given that Dr Dean went on to suggest that Primodos should be withdrawn from use. That indicates that he did see a link between the drug and the miscarriages. Sadly, the suggestion was completely ignored.

Then there are the poor women whose babies had such severe health issues that they did not survive. Reports from those women include the following:

“1971: the words ‘Monster child’ were written on my medical notes. My baby was born alive. I was not allowed to see her. I was drugged. My baby was taken away. I never saw her again.

1971: Anencephaly. Stillborn 2 weeks early. No funeral allowed. Not allowed to name her. My daughter was put in a coffin with a stranger. Searched for 18 years to find where her remains had been left.

1973: I was 16. Just married and excited about my first baby. Just before my baby was born the doctor said my baby did not have a properly formed head. She had no skull and no brain and would die at birth. I was then heavily sedated and my waters broken. I tried to wake up when my baby was born and begged to see her. They refused as her birth defects were too distressing to see.”

I am sure we all agree that those reports are nothing short of heartbreaking. They are incredibly demeaning for the women involved.

To be put through the most horrendous of situations and made to suffer for all these years without answers has been like a life sentence for some, and those living with complex disabilities face an uncertain future without carers or financial support, should their loved ones die before them. If Primodos and other pregnancy hormone tests were to blame, the answers need to come now, and financial support needs to be given before it really is too late to help those living day to day with the effects of innocently taking a drug after putting their trust in clinicians and drug companies all those years ago.

On listening to stories from those affected and researching the issue, the greatest point that sticks with me is the uncertainty that surrounds all the reports that have been published—the lack of evidence used, the lack of research analysed, the lack of questions answered. I think 50 years is long enough for campaigners to wait. I hope that the Minister will today pledge that she will ensure an end to that wait, and that she will make sure that the findings of the latest review, when published, are acted on thoroughly and comprehensively.

Access to Medical Cannabis

Paula Sherriff Excerpts

Monday 8th April 2019 Commons Chamber

[Matt Hancock]

I have already paid tribute to the APPG, and today’s urgent question has demonstrated the breadth of concern in this House. Those who are independent of Government need to make sure that they listen to this level of concern. I am certainly determined to do everything I can to try to resolve this issue.

[Paula Sherriff (Dewsbury) (Lab)]

It has always been the case that the Home Secretary could issue a special licence to allow the medical use of cannabis oil. I understand that the Health Secretary may be seeing him this evening, and I wondered whether he will ask him to consider this course of action.

[Matt Hancock]

One of the great frustrations for me, for the Home Secretary and, of course, for the families is that, before the law was changed on 1 November, that course of action was open. For a few dozen cases, the Home Secretary made those special licences to allow for the use of medicinal cannabis. He and I changed the law together to try to make sure that medicinal cannabis is available on a mainstream basis. Now it is available on a mainstream basis, as a normal drug, it therefore needs clinical sign-off. The problem is there are so many cases where that clinical sign-off has not been forthcoming. That is a source of immense frustration to me, as I hope the hon. Lady can imagine, and it is what we are trying to resolve.

Oral Answers to Questions

Paula Sherriff Excerpts

Tuesday 26th March 2019 Commons Chamber

[Stephen Hammond]

My hon. Friend has been a champion of this cause for a long time, raising the matter on the Floor of the House several times. He can be assured that, as I said to the hon. Member for City of Chester (Christian Matheson), Baroness Harding has been asked to bring forward detailed plans for the cancer workforce in her implementation plan.

[Paula Sherriff (Dewsbury) (Lab)]

Mental health nurse numbers have fallen for the second month running, and learning disability nurse numbers have fallen by 40% since this Government came to power. Nearly 13,000 mental health staff left their roles between May and October 2018, and the vacancy rate is now almost 10%. The King’s Fund, the Nuffield Trust and the Health Foundation say that

“Urgent action is now required to avoid a vicious cycle of growing shortages and declining quality.”

Is it not time for Ministers to start taking such advice, rather than giving it?

[Stephen Hammond]

The Department of course takes such things seriously. My hon. Friend the Minister of State for Care met Baroness Harding last week to discuss how to ensure that there are nurses and carers to help people with learning disabilities. The money that has been promised to make that possible comes in the new financial year, which starts next week.

Draft Social Security Coordination (Reciprocal Healthcare) (Amendment etc) (EU Exit) Regulations 2019 Draft National Health Service (Cross-Border Healthcare and Miscellaneous Amendments etc.) (EU Exit) Regulations 2019 Draft Health Services (Cross-Border Health Care and Miscellaneous Amendments) (Northern Ireland) (EU Exit) Regulations 2019

Paula Sherriff Excerpts

Monday 25th March 2019 General Committees

[Paula Sherriff (Dewsbury) (Lab)]

It is a pleasure, Sir David, to be here discussing the draft regulations. The Opposition have started our speeches on Brexit SIs with a caveat, and I shall do so again this evening, so I apologise for any repetition.

We are now just four days away from Brexit day, as I am sure everyone is well aware. It is deeply concerning that we are still planning for a no-deal scenario when we are so close to the deadline. Once again, we are in Committee to discuss a statutory instrument that would make provision for the regulatory framework after Brexit in the event that we crash out without a deal. On each similar occasion, I and my Labour Front-Bench colleagues have spelled out our objections to the Government’s approach to secondary legislation.

The volume and flow of EU exit secondary legislation is deeply concerning for accountability and proper scrutiny. The Government have assured the Opposition that no policy decisions are being taken. However, establishing a regulatory framework, for example, inevitably involves matters of judgment and raises questions about resourcing and capacity. Secondary legislation should be used for technical, non-partisan, non-controversial changes, because of the limited accountability that it allows. Instead, the Government continue to push through contentious legislation with high policy content via such vehicles. As legislators, we have to get things right. The regulations could represent real and substantive changes to the statute book and they need proper in-depth scrutiny. In the light of that, the Opposition would once again like to put on record our deepest concerns that the process for these regulations is not as accessible and transparent as it should be.

With that out of the way, as always I have some concerns and questions about the statutory instruments. I understand that the three SIs set out provisions for an “orderly wind-down” of UK reciprocal healthcare arrangements with the EU and European economic area in the case of no deal, and that they allow for treatment that is in progress or that was authorised before exit day to be completed on either side of the channel, and—so far as possible acting unilaterally—for reimbursement for those treatments. I also understand that the Department of Health and Social Care regards the regulations as a temporary provision, which, until the Healthcare (International Arrangements) Bill comes into effect, will allow the current system, including the European healthcare insurance card and S1 form, to be continued until 31 December 2020 with individual countries. The Minister has alluded to that.

The transitional elements allow for all ongoing treatment to continue for a maximum period of one year following exit, and for pre-authorised treatments. Similarly, dedicated regulations deal with the special situation in Northern Ireland, where such arrangements are more frequent owing to the land border with the Republic of Ireland. I know that the Department of Health and Social Care regards the regulations as a temporary provision, but an article in The Guardian this week showed that British nationals in Europe feel that the healthcare plans for pensioners are “sick” and “uncaring”. They feel that they are being thrown under a bus and abandoned. They do not think that the one-year undertaking is at all adequate. The Minister will need to deal with the fact that the measure does not reassure many of our fellow citizens living abroad who access healthcare abroad.

As to the Northern Ireland regulations, people need clear guidance to avert harm in the event of no deal. Health services in Northern Ireland and the Republic of Ireland, working separately, often do not have sufficient demand to provide cost-effective, highly specialised medical services. More than €40 million has been invested in cross-border health and social care initiatives via Co-operation and Working Together, a partnership between the health and social care services in Northern Ireland and the Republic of Ireland. Cross-border service arrangements have been established and are currently providing high-quality, safe care for patients, in a range of areas including primary care, cancer services, and paediatric cardiac surgery. Those vital health services must not be destabilised during, or after, the Brexit process, regardless of the outcome.

It is also vital that patient access to key health services is not jeopardised during the Brexit process. Can the Minister provide assurances on that? Will he also agree to an equality impact assessment to ascertain the number of Brits who may lose access to treatment for long-term conditions if his desire for a deal is not realised? It would also be good to understand what the cost would be of any of those Brits having to return home for treatment, as clearly there might be financial implications.

Lastly, on the Social Security Coordination (Reciprocal Healthcare) (Amendment etc.) (EU Exit) Regulations 2019, we are talking about the European health insurance card. Some 27 million of our fellow citizens hold the EHIC and some 190,000 UK pensioners living elsewhere in the EU are registered with the S1 scheme. One week away from Brexit, the NHS England website is still encouraging people to apply for the EHIC, even though it might not be valid in one week’s time, and it is very difficult to see what other advice is available. There is no advice about taking out additional insurance, and no advice whatsoever for those with long-term conditions. That is completely inadequate and it will not do when we are so close to what might be an exit without a deal.

Can the Minister tell me how people will know what to do? How will they go about finding out? When will the NHS website be updated? What will happen to those people, who already feel abandoned, if in just over a week’s time we leave the European Union without a deal and they find that they cannot access clear advice on how to keep themselves and their families safe?

Services for People with Autism

Paula Sherriff Excerpts

Thursday 21st March 2019 Commons Chamber

[Kevin Foster (Torbay) (Con)]

It is always a pleasure to follow the hon. Member for Strangford (Jim Shannon) after a rare opportunity to hear him contribute to a debate. His contributions are always well thought out, passionate and well structured on behalf of his constituents. I definitely agree with him about the need at some point to get the Northern Ireland Assembly back up and running, doing its job again and tackling the issues that need to be tackled on behalf of Northern Ireland. Just ramming business through this place in a day is not what any of us really wants to see. We want to see the politicians who were elected to serve Northern Ireland doing so.

Let me come to the main substance of the debate. I pay tribute to my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan) and to my hon. Friend the Member for Bexhill and Battle (Huw Merriman) not only for securing this debate, but for the passion that they bring to this issue. Obviously, our best wishes go to my right hon. Friend, who is facing a family situation.

This is an interesting debate. When I was about 12, I sat the Mensa IQ test and got a reasonable rating.

[Paula Sherriff (Dewsbury) (Lab)]

Division!

[Kevin Foster]

Yes, thank you—and I like the shadow Minister, too!

That was interesting, because at that rating you are not that far off the autism spectrum. A lot of people forget that the dividing line is not very big. Many people around that mark will show some traits. For example, if we go to a talk on this matter and find someone very interested in politics, when we ask them what party they support, they say, “I don’t really support a party, but I love analysing election nights, with all the statistics.” I asked such a person to reel off election results in the local area—I was in Coventry at the time on the city council, and they were absolutely able to do that, because that was their special interest. They were very passionately interested in politics, but when they were asked, “Which party are you thinking of joining with all this interest?”, the answer was, “Well, I’m not really into that. I’m into the analysis of politics.” That was their special interest.

This is about having a real understanding of autism. What started changing some of my perceptions about people with autism was when I had a volunteer activist who struggled slightly socially in certain scenarios. However, when we were carrying out—of all things—a telephone canvassing session with an automated dialling system, this guy was an absolute star. The rest of us were struggling. The rest of us were finding the whole process very difficult, but he absolutely engaged with it. It was pushing his mind to run slightly faster, and he had ability enough for the whole team. He was given a script, which enabled him to engage brilliantly with people on the phone. That was where his ability came through. In fact, what would normally be seen as a disability became a huge ability. That is why, as a Member of Parliament, I became very keen to challenge perceptions—for example, as has already been touched on in this debate, when someone is seen as naughty. We need to make it clear to employers that, when it comes to people with autism, it is about how they are supported when they enter employment.

I remember doing some work on this with a team when I was deputy leader of Coventry City Council. We looked at why people had left particular jobs—in programming or in engineering. Their skillset was there, their knowledge was there and their strengths were all in that area. What we found was that they were struggling with things such as the lunch room and the office environment—places where they had to interact with people. Everyone else assumes that such interaction is quite simple, but the perceptions of how these people would deal with them were different.

I welcome the fact that support is being provided, but I would be interested to hear from the Minister how much further we can go. We are talking not just about an employer doing a favour, but about an employer sometimes bringing in an absolutely unique talent who may be able to address a job in a way that, bluntly, most of us in this Chamber would struggle with. Sometimes the way an autistic mind works can become a massive advantage in engaging in areas such as IT and tech.

That all means that we need the appropriate levels of support. I do have some concerns over the pressure on higher needs funding in Torbay. I recognise that the Government recently provided some extra funding, but there has been an issue in Torbay. I do not think that we are unique in this, as some of the other smaller coastal unitaries face an issue with the deficit. Traditionally, their funding levels are lower than other areas, which makes it harder for them to deal with such issues. They are paired up with larger—bluntly, more wealthy—counties.

We also need to be clear that this issue is not just about learning, but about having fun. I welcome the fact that support services are available in the Bay. For example, the ASRUS Group meets at the YMCA in Dartmouth Road, Paignton. It is not just about providing education support, but about providing social support to build skills.

This has been a worthwhile debate. I have enjoyed sitting through most of it and listening to the contributions. It will be interesting to hear from both Front-Bench speakers what their thoughts are on this subject. Some people who have absolutely unique talents and some of the greatest minds on this planet may be just on the autistic spectrum, or only just below it. That is where we need to change our perception. It is not about someone with a disability, but about someone who may have a unique ability that we could unlock with the right support.

--- Later in debate ---

[Paula Sherriff (Dewsbury) (Lab)]

Our thoughts are with the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan), who is a true champion for those with autism. I also thank the hon. Member for Bexhill and Battle (Huw Merriman) for securing today’s debate and his excellent speech, which set the tone for a very constructive debate.

This is a timely debate not just because it comes in advance of World Autism Awareness Week, but because this year marks the 10th anniversary of the Autism Act 2009, passed under the last Labour Government, which put a duty on Ministers to publish and regularly review their autism strategy and to produce statutory guidance to implement at a local level. We have heard from several hon. Members on the all-party group on autism, which is holding an inquiry into the Act’s implementation ahead of the Government’s review. Ahead of that formal publication, I hope that the Minister will give us the Government’s views not just on the changes that we have seen over the past 10 years, but on what more can be achieved in the years ahead.

I am sure that the whole House will want to thank the National Autistic Society, Autistica and Ambitious about Autism—and all the other charities that represent and serve people with autism—for the work they do, the support they give and the services that they provide to all those people. There is a charity in my constituency called The Whole Autism Family, which is run by Martin and Anne-Marie Kilgallon in Mirfield, who do phenomenal work. They have two sons with autism, but the support they provide to other families is simply phenomenal and I am very grateful to them for their work.

In responding for the Opposition Front-Bench team, I think it is important to note that, although I am shadow Minister for mental health, autism is not a mental health condition, as the hon. Member for Berwick-upon-Tweed (Anne-Marie Trevelyan) also mentioned. I hope that we all aspire to a society where people with autism have as good mental health as the rest of the population. Unfortunately, however, we are very far short of that aspiration. It is estimated that up to four out of five autistic people develop mental health problems such as anxiety and depression, and four out of 10 children with autism have multiple mental health problems.

In the worst cases, autistic people end up in mental health hospitals, which are usually not appropriate, and they are sometimes there for extended periods. The transforming care programme was aimed at tackling that problem, but we have heard evidence that it has fallen far short of its aims. The NHS long-term plan sets a target for reducing the number of autistic in-patients in mental health hospitals by 2023-24. But if we are to achieve that, there must be investment in better community mental health support that is appropriate for people with autism. The need to tackle this issue has been thrown into stark relief by the appalling cases of abuse of people with autism that have had significant media coverage in recent months, as the hon. Member for North Cornwall (Scott Mann) mentioned.

There are still more than 2,000 people in totally unsuitable in-patient settings, when they should be supported in the community. That is not only unconscionable; it is exorbitantly expensive, with the average package costing £3,500 a week. The Government announced last year that they would be asking the CQC to conduct a thematic review into the seclusion of people with autism in in-patient settings, but this will take far too long to tell us what we already know—that these placements should be ended. Will the Minister today finally commit to ending placements in assessment and treatment units and to working with her colleagues to provide the kind of community-based support that people with autism deserve? The Minister will also be aware of the call to reform the Mental Health Act 1983, which defines autism as a “mental disorder”, allowing autistic people to be sectioned without having a separate, treatable mental health condition. Perhaps she can tell us what plans there are to address the legislation, as well as to provide the right kind of support services.

Perhaps the obvious starting point regarding support for people with autism is getting a diagnosis in the first place, and a number of hon. Members have quite rightly spoken about that today. The quality standard on autism recommends a maximum three-month period between referral and the first diagnostic appointment, but it is clear that the standard is not being met anywhere near widely enough, with reports of delays of years rather than months. I have certainly experienced that issue in my constituency surgeries.

When I spoke on this subject a year ago, I noted that we were about to implement new standards on data for waiting times, which had been patchy until then. We are now nearly a year on, and we should therefore have data for the first full year next month, with publication due this summer. The long-term plan also contained a welcome and specific commitment to reducing diagnosis times, so I hope that the Minister will update the House on any early findings, on when the final data will be published and on the Government’s plans to make improvements.

Similarly, in previous debates, we have heard about the need for better data on who is being diagnosed. The National Autistic Society found that over three quarters of those using their adult services are male, and there is a concern that the lack of recognition for women with autism may be partly behind those numbers. There are also age effects, given that autism was not a recognised condition when many older people with autism were growing up. In previous debates, the Minister has said that the Department expects GPs to include autism in the primary care register and will be working with NHS Digital to achieve that. Perhaps the Minister could update us on the progress in that regard.

Too often, there are significant barriers to accessing the right services after diagnosis. One recurring theme is the need for better training, which the guidance states all staff should have access to, but the reality sometimes sadly falls short. Last month, the Government launched a consultation on mandatory training, which is welcome, but for this to work it must be co-designed and co-delivered by people with autism. Can the Minister tell us whether this will be the case and, perhaps more importantly, whether her Department will provide funding so that the autistic people providing their experience to this training receive a proper wage for their labour?

Early intervention services are key for communication and language skills, which are closely linked to life chances for people with autism. In education, too, services for children with autism and other special needs have been first in line for cuts, as we have heard from other hon. Members. With the Government taking billions out of the schools budget between 2015 and 2017, I know all too well the pressure that schools in my constituency are under. As the vast majority of school budgets are spent on staff, this is the area of greatest pressure. For example, the support staff, who are so vital to children with special educational needs, are often the first to go, and one-to-one support for children becomes impossible when the money simply is not there. Thousands of children in England with approved education, health and care plans are still receiving no provision, and that proportion has increased fivefold since 2010.

If we let children with autism down in education, the impact is felt when they become adults seeking employment. My hon. Friend the Member for Bristol West (Thangam Debbonaire) spoke with great knowledge about the challenges of employment for those with autism. There is an urgent need for improved in-work support services for disabled people across the board, and the autism employment gap is even wider than the disability employment gap. Over the past 10 years, there has been no real change in the numbers of autistic people in full-time work, and the National Autistic Society found that less than a third of autistic adults are in paid work, even though more than three quarters do want to be in a job.

The NAS has called for an autism employment pathway, an awareness programme for employers and targets for getting people with autism in to work. I hope that the Minister can tell us the Government’s response and address points such as making sure that Jobcentre Plus staff understand autism and responding to the call for autistic people in work to be recorded in the labour force survey. Apprenticeships and other specialist schemes could also provide a route into employment, with tailored support for people with autism. Will the Minister update the House on progress in implementing the recommendations of the taskforce chaired by the hon. Member for Blackpool North and Cleveleys (Paul Maynard) and on what steps the Government have taken to expand the Disability Confident scheme?

Finally, there are the services aimed not just at people with autism but at the rest of us to ensure that we are aware and understand the condition. The research has long shown that most people with autism feel that their condition is not understood, as was recently highlighted by the National Autistic Society’s “Too Much Information” campaign. Only 16% of autistic people and their families think the public understand autism, and half of autistic people and their families are sometimes afraid to leave the home because they are worried about the public’s reaction. The contributions we have heard from Members across the House today show just how much more there is to be done to provide the services that people with autism need. I hope that the Government have heard that message and will now act on it.

Eurotunnel: Payment

Paula Sherriff Excerpts

Monday 4th March 2019 Commons Chamber

[Matt Hancock]

Of course that matters enormously, too. Although medicines are the category 1 prioritised goods that will be using the extra procured capacity safeguarded by this settlement, there are other measures being undertaken by the Department for Environment, Food and Rural Affairs to protect the supply of foods.

[Paula Sherriff (Dewsbury) (Lab)]

That £33 million would pay the annual salary of 118,000 nurses, and God knows we need them. The NHS has 40,000 nursing vacancies in the NHS in England. Does the Secretary of State for Health think that the cost of the latest blunder of the elusive Secretary of State for Transport is money well spent?

[Matt Hancock]

Well, I do think that it is very important that we spend what is necessary in order to have the unhindered supply of medicines. [Interruption.] The hon. Lady shakes her head, but would she, in these shoes, put at risk the unhindered supply of medicines? Of course she would not, so she must agree with me that this was the right decision to take.

Health and Social Care Committee

Paula Sherriff Excerpts

Thursday 28th February 2019 Westminster Hall

[Dr Williams]

I thank the hon. Member for the contribution that she has made to the Health and Social Care Committee, and to our thoughts in developing these ideas. We learned during our inquiry that fathers often feel excluded—systematically excluded. Much of the literature and many of the interventions are targeted at mothers. Culturally, services tend to push fathers a little bit further away, rather than bringing them in.

We recommend that the healthy child programme becomes a healthy family programme, and of course we know that every family is different. Families have different members; in some families, grandparents play a huge role, and in others, a lesser role. Our main recommendation is about a cultural emphasis, or a cultural change, in the healthy child programme, to make it a more holistic family experience.

[Paula Sherriff (Dewsbury) (Lab)]

I congratulate my hon. Friend on a very thoughtful—indeed, excellent—speech, and I look forward to reading the report in full. I am also very grateful to him for the work that he does on the all-party parliamentary group on the prevention of adverse childhood experiences.

I will talk a little about the service in my area through which mums who may be prone to post-natal depression are identified, even prior to conception. If men and women who are thinking of conceiving have a history of mental illness, or perhaps even fairly low-level depression or anxiety, they are identified, and the mental health support team work with that couple throughout pregnancy and then after the child is born. I note that my hon. Friend identified mental health as one of the key issues in relation to adverse childhood experiences, but would he welcome a wider roll-out of this kind of work, to support children’s first years?

[Dr Williams]

I thank my hon. Friend for emphasising maternal mental health. The Government have made significant progress in improving services, particularly for people with more severe perinatal health problems, but we still have too many cases where people are likely to develop mental health problems, even if those problems are not predicted, and who say they have mental health problems in the perinatal period, but services do not detect those problems. The National Childbirth Trust has estimated that perhaps up to 50% of mothers with perinatal mental health problems never get asked about their mental health. It is welcome that some areas of the country are responding to that issue in an assertive way and seeking to prevent perinatal mental health problems, rather than just detecting them early. However, we are left with a lottery, whereby some areas do this work exceptionally well, and other areas still have to catch up.

The idea of a local authority-led plan, with some central accountability, might help to bring the kind of services that are obviously being provided already in Dewsbury to many other parts of the country.

Eating Disorders Awareness Week

Paula Sherriff Excerpts

Wednesday 27th February 2019 Westminster Hall

[Paula Sherriff (Dewsbury) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Bailey. I sincerely thank the hon. Member for Angus (Kirstene Hair) for securing this very important debate today, particularly during Eating Disorders Awareness Week. I was deeply moved by her powerful opening speech and I thank her and the hon. Member for Bath (Wera Hobhouse) for their persistence in bringing the issue to the House. May that never stop.

It is only four months since we were last here speaking about this issue and how we could work together to remove the stigma around eating disorders. Many colleagues here today also spoke in that debate and I thank all of them for taking the time to be here again today. I have been struck, as I am sure many have, by the collegial nature of this debate. That is important and it is what people who experience eating disorders, and their families, want. They want us to put our party colours to one side and work together to try to bring about the much- needed improvements in this area.

My hon. Friend the Member for Islwyn (Chris Evans) talked eloquently and powerfully about the issue. As we all know, it is brave to talk about our personal experiences in this place, and he talked about his own experience of body dysmorphia. He also talked about the bravery of others, but I hope he takes time to reflect on his own bravery and courage. I am very proud of him and I thank him.

I also want to reflect on the comments made by the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) about what happens in schools, which is incredibly important. The hon. Member for Angus also touched on it. I recently attended one of the high schools in my area and talked about what psychological support was available to children, specifically teenagers.

[Jim Shannon (Strangford) (DUP)]

I apologise that I could not be here earlier; I was at the Northern Ireland Affairs Committee. Over the years, I have had the opportunity to help some of my constituents, particularly ladies, who have had eating disorders, and we have been able to sort those things out. I have noticed a dearth among males, who unfortunately seem not to address these issues. I commend the hon. Member for Islwyn (Chris Evans) for speaking about that.

The hon. Lady talked about helping schools, youth groups, and other youth network facilities. I believe that there is a need for trained officials who can notice disorders and step in early. Early diagnosis and early intervention is the way forward. Does she agree?

[Paula Sherriff]

I thank the hon. Gentleman for his intervention. Frankly, a debate would not be complete without an intervention from him. I absolutely agree. When I was speaking to the professional at the Mirfield Free Grammar, she told me that much of what comes through her door relates to eating disorders, crucially in boys as well as girls. Sometimes we continue to stereotype that eating disorders affect only women. The reality is quite different.

As a number of Members have suggested, social media can be a double-edged sword. I will talk about Beat in a moment. Beat does excellent work and has fantastic online resources, as do a number of other mental health charities. However, other sites that we have heard about that encourage people with regard to suicide and their eating disorders can be problematic to say the least.

The Government have made a commitment that, by 2020, 95% of children and young people who are referred with an eating disorder will be seen within one month, or one week if it is considered urgent. That is obviously very welcome, but with 2020 just around the corner I am concerned that, given current workforce and funding pressures, that will be difficult to achieve, or will possibly result in manipulation of waiting time figures. A patient will get a first appointment within the timescale, but any follow-up or effective treatment will still come many months, or even years, after referral. I would be grateful if the Minister would say how it will work in practice.

Although that is all well and good for children and young people, there are still no clear plans for adults with eating disorders. I recently visited a NAViGO service in Grimsby that supports people with eating disorders, and I was struck by how many people who were older than me were experiencing in-patient treatment.

My hon. Friend the Member for Newcastle-under-Lyme (Paul Farrelly) talked about his constituent Sarah. I have a constituent who was diagnosed with an eating disorder at 16. Owing to the severity of her illness, she was sadly admitted to hospital for a lengthy stretch. On her release, she attended fortnightly appointments with an eating disorder specialist. As her recovery was going well, my constituent decided that she would like to take up an offer of a university place in Manchester, because despite her very difficult illness she had achieved the most fantastic A-level results. She saw going to university as a positive step in her healing and as a way of getting on with her life. The local NHS trust that delivers mental health services in my area informed her that she would have to transfer over to mental health services in Manchester.

Neither my constituent nor her family thought too much about that, as it was not raised in such a way that allowed them to foresee any issues. However, five months on, my constituent is still waiting for the handover to be completed and, sadly, during that time she has suffered a serious relapse and is once again looking at in-patient care. I recently attended the all-party parliamentary university group, and we talked about transition when people go to university, and about mental health in general. We need to look at that in some detail.

[Paul Farrelly]

Clearly, the administration in the health services that led to that outcome is of grave concern. It is also concerning when specialist services in a particular area stop for young people when they turn 18. Only those people going away to university or college in areas that provide such services, or those people whose families have a lot of money and can fund treatment privately, have the prospect of change. The people who are left are effectively discriminated against.

[Paula Sherriff]

I thank my hon. Friend for that intervention. I absolutely agree. We had a very interesting discussion at the APPG about whether we could do more pre-screening when people go to university. We must also remember those in further education, not just those in higher education.

I ask the Minister whether what happened to my constituent would have happened had she been suffering from a serious physical condition. Earlier, a colleague made an analogy with cancer—“Your cancer is only at stage 1; we’re not going to treat you until it becomes more advanced.” As we all know, eating disorders carry the highest mortality rate of any mental illness; yet this young lady has been left to suffer, in a new city, away from family and friends and without any support network. We all have to ask ourselves how on earth that was allowed to happen.

I commend the fantastic work being done to raise awareness of eating disorders and to support sufferers, and crucially their carers and families, by the charity Beat, some of whose representatives are in the Gallery. They work relentlessly to battle against the stigma of this dreadful disease, and to push for better access to services and treatments. When my office spoke to them about the case of my constituent, they said that sadly it was very typical of the stories that they hear every day on their helpline. How many families are going through the same mental torture day after day while waiting for that elusive appointment confirmation to drop through their letter box?

With no specific waiting time targets for adults with eating disorders and poorly funded mental health services, many overstretched mental health trusts are unable to put the necessary resources into those vital services, and treatment availability has become a hideous postcode lottery, as my hon. Friend the Member for Newcastle-under-Lyme highlighted. Service access and levels of funding vary widely from one area to the next.

Furthermore, there is a huge disparity between access to adult services and to those for children and young people, with adults on average waiting twice as long. The eating disorder charity Beat has had a huge rise in calls to its helpline over the last year. In 2017-18, Beat staff helped 17,000 people, and they estimate that by the end of 2018-19 they will have helped more than 30,000. It is commendable that they managed that increase in demand so well, and I know that with more funding they could help even more people.

In October 2018, following an eating disorder storyline, which Beat had been very involved in helping with, on the popular teenage soap “Hollyoaks”, calls to Beat’s helpline spiked to more than double those in any previous month. That highlights the need to raise awareness about eating disorders and, crucially, to quash the stereotypes and stigmas so that more people know that they can seek help earlier. Reportedly, it could take an adult with an eating disorder more than two years before they realise that they have an issue, and up to another two years to seek help. More needs to be done to increase awareness and access to treatments.

Beat recently undertook some research into eating disorder stereotypes. When people think of eating disorders they often think of young, white women, but that is a popular misconception. The reality is much more complex. More adults suffer from eating disorders than young people, and the number of male sufferers increases year on year, with people who identify as LGBT+ at significantly higher risk. Stereotypes prevent people from seeking and receiving medical treatment in the earlier stages, which, in turn, makes it harder for people to recover.

I am grateful that the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) raised over-eating. When we think of eating disorders, we often think of anorexia or bulimia. It is important that we consider the full spectrum of disorders. Beat’s research also found that people from black, Asian and minority ethnic and less affluent backgrounds would feel less confident in seeking help from a health professional for an eating disorder. That stigmatisation and fear of speaking out can have far reaching and dangerous consequences.

We also need to work to ensure better training for those on the frontline. The hon. Member for Westmorland and Lonsdale (Tim Farron) made an important point about training for those in health professions so that they can better recognise and support those who present with eating disorders.

Another constituent of mine waited more than two years to be seen by a psychiatrist for depression and anxiety. During that time, sadly, she also developed an eating disorder. She was consuming less than 700 calories a day and avoiding any foods with even a trace of fat, and her weight had plummeted over a period of six months, but at her first psychiatric appointment she was told that she was not underweight enough to be considered to have a serious eating disorder. At her second appointment, the psychiatrist weighed her and congratulated her on her increased weight and body mass index. As hon. Members can imagine, that was the last thing that she wanted to hear. The psychological effect set her recovery back by weeks.

Sadly, that was not an isolated incident. There are many fantastic people working on the frontline of our health services, but there is also a minority who would hugely benefit from extra awareness training in what an eating disorder looks like, how best to treat it and where to refer patients for treatment.

I know the Minister well and am satisfied that she has huge compassion in the area, but equally I hope that she has listened to the points raised in this debate and will press the Government to put eating disorders higher up the agenda, make promises and set targets that will ultimately save the lives of sufferers. She will have my full support in doing so.