GP Contract
Perran Moon Excerpts(5 days, 18 hours ago)
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Stephen Kinnock
On prevention, there are some really important measures in the contract: in essence, we are recalibrating the quality outcomes framework, which is the basis for payments to incentivise the actions that GPs take. By changing the QOF, as it is called, we can shift that in one direction or the other, and we have changed it to incentivise boosting childhood vaccination rates, particularly in those areas of the country where vaccination rates are worryingly low, and better care for patients living with obesity. That is about exactly the things the hon. Member just mentioned: prescribing, if you like, exercise regimes and advising on better nutrition. We are also changing the QOF to require GPs to share data with the lung cancer screening programme. Those are just three examples of what we are doing within the contract.
On online access, it is clear that there must always be three channels of access to a GP—walk-in, telephone and online—and that for an urgent matter it would be a walk-in or a telephone call. What has really worked is that online access has taken pressure off the telephone lines as people who do not have urgent requirements have been migrating online and using the NHS app—take-up of the app is also excellent—so we are moving in the right direction.
Perran Moon (Camborne and Redruth) (Lab)
My father was a family doctor in my Camborne, Redruth and Hayle constituency for more than 40 years; now that he is in his 91st year, I am thankful he is no longer practising. I have the highest number of deep-end group GP practices in my constituency, including the one where my father practised. While I welcome the consideration for deprived areas, will the Minister elaborate on what targeted funding there will be for areas with the highest levels of deprivation?
Stephen Kinnock
I thank my hon. Friend for that question and ask him to please pass on my best wishes to his father and thank him for the outstanding service he provided over many years. The Carr-Hill formula review is an important piece of work. It will have a complex range of drivers in it, based on remoteness and coastal areas, but socioeconomic indicators will be very much at its heart. Those are the clear terms of reference that we gave to the National Institute for Health and Care Research, and that is the basis of the review. I expect those documents from officials very soon, and we will update the House accordingly. Some of the process was set out in a “Dear Colleague” letter a little while back, but we are also keen to have feedback from MPs in that process.
Funeral Directors: Regulation
Perran Moon Excerpts(1 week, 5 days ago)
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Dame Caroline Dinenage
I thank my hon. Friend for listening to me on this issue when he was the Justice Minister, when I first brought his attention to the situation. The points he makes are absolutely right. Over the past couple of years I have met the two voluntary trade bodies for the funeral sector, the National Society of Allied and Independent Funeral Directors and the National Association of Funeral Directors, as well as countless reputable funeral businesses and, crucially, many of the families impacted by these cases. I am so grateful to all of them for the time that they gave me, but as my hon. Friend said, every single one of them has stressed the need for the sector to be better regulated. I echo his calls for the Minister to give us some good news on that in a minute. That is important for everybody; otherwise, all those who carry out their work with such enormous care and diligence will have to operate under the shadow of suspicion. We owe it to them as much as anyone else to get this right.
The Minister knows that malpractice is not uncommon. Quite simply, taboos and sensitivities around death have effectively created a smokescreen for bad care. I am especially concerned about one area: the rise in direct cremations. For those who do not know what that is, it is where the loved ones do not see their deceased at any point in the journey. In their cases, there are absolutely no safeguards, checks or balances. The key thing here is that direct cremations have expanded hugely in the last few years, partly as a result of covid, from just 3% of funerals in 2019 to 20% in 2023.
We all see the charming adverts on the television in which an elderly gentleman explains with a smile that he has arranged for himself a direct cremation. He says, “I just didn’t want any fuss. It is much easier for my children.” We know that some very reputable and caring businesses do this process, but if the children knew what direct cremation might be, they would know that it might be little better than a conveyor belt. Mum and dad may be bundled into a van, maybe still in their soiled nightclothes, with a catheter attached and without any form of temperature controls. They could be taken to an unknown location and left for days before a slot becomes available at a crematorium. Who knows? In the hands of an unscrupulous company—who knows which ones they are?—it is all too possible for any human dignity and respect to become a completely unnecessary complication and expense in this process.
The only requirement before cremation takes place is that the body needs to be rid of objects such as pacemakers and other medical equipment. That was another part of my journey through understanding this process. This surgical procedure is carried out by embalmers, who also drain the body of blood in order to replace it with embalming fluid and remove the contents of the stomach. I was really shocked to learn that that can be performed without any accreditation or qualification whatsoever, and with no minimum standards of care for the body. That is not to say that there is not a form of qualification—the British Institute Of Embalmers provides professional training, and reputable companies such as Co-op funeral directors require a level 5 apprenticeship qualification for their embalmers—but it is not mandated to be able to practise.
In a nutshell, if the political career of any one of us in this room did not work out, we could walk out of here and set up our own funeral home—in our house, if we wanted to—with no special skills or accreditation and nobody inspecting our work. With that as the starting point, who can ever say for sure that their family member was treated with the appropriate professionalism? I have a question for the Minister; I know he has been hoping that I would get to this for some time. What can the Government do to restore trust in this sector? It is unfair on those who practise with enormous integrity that their professionalism is being called into question.
The Minister will know that the Fuller inquiry was set up in the wake of the crimes of the necrophiliac David Fuller, who abused 100 dead women and girls in a hospital mortuary in Kent. Those women were between the ages of nine and 90. In the wake of cases such as those in Hull and Gosport, Sir Jonathan Michael, who led the work into the Fuller report, was asked by the Government to prepare stage 2 of the report, which considers the wider funeral sector and those working in it. The report was published last July and includes some very sensible recommendations, including a statutory regulatory regime for funeral directors that invokes a licensing scheme, mandatory standards and regular inspection.
Perran Moon (Camborne and Redruth) (Lab)
This is a really important debate. While regulation of the funeral sector is fundamental, does the hon. Member agree that it must be proportionate? A small, independent home carer for 20 or 30 people a year cannot be expected to have to mirror the administrative burdens placed on a large, multi-site corporate provider. Does she agree that core standards must be universal, but related to the structure and scale of a business?
Dame Caroline Dinenage
I do not think that the size of a business is necessarily any reflection of its professionalism. We know that a large number of small, independent funeral services up and down the country work with incredible professionalism.
The hon. Gentleman is also right that nothing should be introduced that is unnecessarily bureaucratic or costly for those businesses.
The Fuller report says:
“It is important that real change is implemented to ensure the security and dignity of the deceased, and that a specific government department is given responsibility for overseeing this.”
Everybody who is involved in this sector recognises that there is a need for it to be properly regulated, inspected and overseen, so can the Minister set out clearly what his initial thoughts are on the recommendations of the Fuller report and when the Government will respond to them in full? When they do so, will they set out clearly what firm action will be taken, and when? We have waited so long, so when the Government respond, it must be with clarity, with purpose and—above all—with urgency.
ADHD Diagnosis
Perran Moon Excerpts(2 months ago)
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Bill Esterson
Yes, I agree with the hon. Member. It is important to realise that everybody is different and that we all need different support. That is very true in school. When we call for diagnosis, we need to take great care around what we mean. Diagnosis is a means of getting support, getting the right treatment and getting the right medication, if medication is right—it is not right for everybody. ADHD is a spectrum and that individual, tailored support in school, and indeed in adult life, is an important part of what we are discussing.
Bill Esterson
I am glad that my hon. Friend raised that point, because one of my asks to the Minister is to iron out those inconsistencies.
Perran Moon
I thank my hon. Friend for securing this important debate, and thank the parents of Matty Lock for being in the Public Gallery for it. A couple of years ago, my son was diagnosed with ADHD while he was at university. To my shame, I always thought that his behaviour was simply a case of mischief or laziness. Does my hon. Friend agree not only that it is a case of early diagnosis, but that we need to increase awareness of ADHD—and neurodiversity more broadly—among parents, guardians, medical professionals and Government?
Bill Esterson
My hon. Friend is absolutely right, and he has made a very good point. My son has been diagnosed with ADHD—belatedly, like so many—but we were told early on that having a diagnosis would not help him. How wrong that was, because the diagnosis was the key to getting support and understanding what we were dealing with, both for him and for us as his carers. There is a lot of misinformation around, and getting that right is key, but yes—
Oral Answers to Questions
Perran Moon Excerpts(7 months, 3 weeks ago)
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Karin Smyth
The provision of car parking remains an issue for trusts. I recognise the stress caused by trying to get patients to hospital, particularly if they have mobility problems. I commend the many hospitals across the country that have really good active travel plans and are working with their local communities to resolve some of these issues. We need to hear more from the trust about what provision it is putting in place to serve my hon. Friend’s constituents.
Perran Moon (Camborne and Redruth) (Lab)
Perran Moon
Meur ras, Mr Speaker. Carn to Coast runs GP surgeries across my Camborne, Redruth and Hayle constituency, including the surgery where my father practised for over 30 years. It is struggling under intense pressure, with deep-rooted health inequalities linked to the surrounding areas of deprivation. While I welcome the review of the Carr-Hill formula as part of the 10-year health plan, will the Secretary of State come to Cornwall and visit a Carn to Coast health centre with me, to see the innovative work that is already being undertaken and to discuss how the reforms will support health outcomes in the most deprived areas?
Wes Streeting
I can certainly give my hon. Friend that commitment. The damage that was wreaked by the previous Government, not just across our health service but across every other part of Government, means that the gap between the health of the poorest parts of our country and that of the wealthiest has widened enormously. We have seen real challenges in general practice, which is why there are 300 more patients per GP in the poorest communities compared with the richest, and that particularly affects rural and coastal communities with higher levels of deprivation. We are going to carry out a review of the Carr-Hill formula. That formula has to work for general practice, and I would be delighted to come and see the work that the team at Carn to Coast are doing.
Oral Answers to Questions
Perran Moon Excerpts(9 months ago)
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Wes Streeting
May I respectfully say that that was part of the problem with Conservative thinking? They thought that the answer to the NHS crisis was more quangos, and they measured success in the number of ICBs, not the number of appointments and the size of the waiting list. We are taking a different approach, slashing bureaucracy and reinvesting in the front line. We are not centralising but decentralising, and cutting waiting lists—a record that the Conservative party cannot begin to touch.
Perran Moon (Camborne and Redruth) (Lab)
A couple of weeks ago at my constituency surgery, though tears my constituent Amy explained how, following a hip operation in 2008, she suffered progressive nerve damage due to repeated failures in diagnosis, referral and treatment. Despite raising concerns for years, she was told that her pain was common. A nerve test in 2015 confirmed damage, and further tests last year showed a significant deterioration. After 17 years she has only now been offered surgery. All Amy wants to know is what steps are being taken to ensure that no other patient is left permanently disabled due to such prolonged and systemic failure—
Mr Speaker
Order. That is very important, but why does the hon. Member not want others to get in?
Hospitals
Perran Moon Excerpts(10 months, 3 weeks ago)
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Josh Fenton-Glynn (Calder Valley) (Lab)
Today’s debate is a welcome chance to talk about the challenges of our health service. The Darzi report was a stark demonstration of the state in which the health service was left by the last Government. I know that part of the game today is for our colleagues on the Liberal Democrat Benches to say, slightly deceitfully, “Oh, the Labour MPs are supporting the delay.”, but Members across the House will know, if we are honest with ourselves, that we cannot delay something that was not going to happen.
What of our inheritance? It stretched far further than just the buildings; it included the staff and the patients in them, weakened by austerity and decimated by covid. Lord Darzi talked about £37 billion of under-investment in our hospital buildings in the 2010s. On top of that, what else did we inherit?
Perran Moon (Camborne and Redruth) (Lab)
Does my hon. Friend share my real discomfort at the gall of the hon. Member for Henley and Thame (Freddie van Mierlo) in suggesting that somehow this Government are making the same mistakes that the Conservative Government made, when it was in the 2010s—under a coalition Government—that the rot started, with the Liberal Democrats?
Josh Fenton-Glynn
I think if the hon. Member for Henley and Thame (Freddie van Mierlo) were to reflect on what he said, he would know that these things always go a lot deeper.
What have we inherited? We inherited 14,000 unnecessary deaths in A&E alone each year. NHS waiting lists peaked at 7.7 million. That is people waiting anxiously, needing treatment, tumours growing, their bodies getting further from being well, and every day 2,000 people were being sent to hospital who did not need to be there, because social care had been failed and forgotten by the previous Government and by the coalition Government. In my constituency, that means 20% of beds in our hospitals are taken up by people who do not need to be there.
We have work to do, and I am concerned that in this debate we will get caught up in a discussion about hospitals and will not fix the systems within them that we need to fix. That is why we have talked about three shifts. The first is from hospital to community. We have to stop people needing hospital care because they have been failed by care closer to home. That is why our revolution in GPs will make a real difference. The second is the shift from fitness to prevention. We can have the best buildings, but with less prevention they will still be full. Finally, there is the shift from analogue to digital; every week, the Health and Social Care Committee hears about people caught between systems and between computer systems.
Although I welcome this debate, we must not fetishise buildings over people. We need to think holistically about our system and deliver the decade of national renewal that the public voted for. We need to look at all of our health service, across parties and in good faith.
Eating Disorder Awareness
Perran Moon Excerpts(11 months, 2 weeks ago)
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Perran Moon (Camborne and Redruth) (Lab)
Meur ras, Mr Stuart; thank you for your chairship. I thank the hon. Member for Bath (Wera Hobhouse) for securing this important debate. I declare an interest: I am also a member of the eating disorder APPG.
As has been mentioned, recent data suggests that one in eight 17 to 19-year-olds in England have an eating disorder—a massive increase from fewer than 1% in 2017. On average, young people are now waiting for almost three and a half years to get treatment.
My relationship with anorexia began nine years ago. It is a story that I am sure resonates with many thousands of other parents the length and breadth of Britain; frankly, it is a massive part of why I became an MP. My story began when I took a phone call from a teacher at my daughter’s school. She asked me to come and collect her, as she had passed out, having not eaten breakfast or dinner.
Over the next few months and years, my daughter, whose relationship with food had already become terribly distorted, unbeknown to me, was clutched by anorexia. Its claws dug deeper and deeper into her as she slipped into a desperately poorly state. She became too unwell for school, and the pressure of her exams was like a ton of bricks on her as the anorexia gave her a cruel outlet for the control—something that sits behind so much of this—that she sought in her life.
As parents, our most solemn undertaking is to protect and nurture our children. Against this terrible illness, I was utterly useless. As my daughter’s illness took hold, I became more and more angry: first with her, then with others, and then with the system. It was only years later that I had to have it explained to me that that anger was actually driven by fear. I was impotent to support my daughter. Worse still, I was incapable of finding anyone else who could provide her with the care that she so desperately needed.
Here is the killer blow. The only way she could qualify for lifesaving support was if she became critically ill—so ill that she was staring death in the face. Imagine sitting at the kitchen table for hours, watching your emaciated child looking terrified at a small plate of food in front of her and hoping that she does not eat it, so she becomes so ill that she qualifies for the support that she needs. Those truly shameful thoughts are etched on my conscience and visit me every single day. They have left an indelible stain on my soul. For having those terrible thoughts, to my daughter, wherever she is, if she sees this speech, I want to say, “I’m sorry, my lamb.”
Wera Hobhouse
I congratulate the hon. Member on being so brave in talking about his own experience. I, too, have a daughter who suffered from an eating disorder; she was not quite as ill as he describes his daughter being, but I am still visited by those hours—though they were many years ago—when I was gripped by fear and anxiety. It is only by sharing these stories that we can ultimately bring all this to light, so again I thank him for being brave enough to share that.
Perran Moon
I thank the hon. Member. How could a system be so warped as to make a parent feel that way about their own child—the thing they love most, more than anything else in the world? Measuring the criticality of eating disorders through BMI is a medieval evaluation, hopelessly inadequate to the needs of the sufferer. Proper psychological assessments must be undertaken at the earliest identification of a problem, with a package of appropriate measures applied thereafter, dependent on the severity of the case.
My daughter spent two periods of six months in hospital. She recovered her health and is today working in the NHS in mental health services as a senior assistant psychologist, using her own painful experience to offer others the care and support she never had. Under-investment has left mental health services stretched beyond capacity, and young people like my daughter become desperately unwell while sitting on waiting lists, with the cost of their recovery, both emotionally and financially, spiralling by the day.
I know the Department of Health is taking the issue incredibly seriously, but we must prioritise a rapid overhaul of the system to offer hope to young people and their families. This Government must prioritise investment into mental health and eating disorder services. Today, I ask the Minister to say to all the families going through that hellish tornado of pain, to all those angry dads, tearful mums and terrified children, “Hang in there. We will come for you. We know your pain and we will act swiftly to help you to relieve it.”
New Hospital Programme
Perran Moon Excerpts(1 year, 1 month ago)
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Dr Mullan
Governments make choices. I have just laid out the economic situation that we inherited, which was worse than the one Labour has inherited, and yet we prioritised NHS spending. Nobody forced Labour to give above-inflation pay increases to a number of public sector workers and enormous pay increases to train drivers, or to make a significant but unwise investment in the green investment plan.
Dr Mullan
There is not time for a continual back-and-forth in a 30-minute debate, so I will make some more progress.
When it comes to comparing the record of the NHS, the performance of the NHS under Labour in Wales, across many of the metrics that Labour Members have criticised us for, is actually worse than the record of the NHS elsewhere. That is because across England, Scotland and Wales—this is why I hope we can come to some agreement—we not only had the pandemic but face an increasing demographic challenge.
The SNP, Labour and the Conservatives, in the three areas in which we respectively have responsibility for health, are seeing considerable challenges that all of us are struggling to manage, as the Labour party will now struggle to manage them. As was the case when Labour was last in office, capital spending is often deprioritised when budgets are challenged, and decisions are made that might make sense in the short term but that also create long-term pressures.
The issue that we are debating is nothing new. Members from both sides of the House agree that our hospitals need modernisation, with 42% of the NHS estate having been built before 1985 and 14% of the estate pre-dating the NHS.
Perran Moon
I thank the hon. Member for giving way. I appreciate that he does not want this debate to be political, but so far it has been all about politics. If we want to have a debate about the state of the NHS and how we transform it, it must be a level debate.
In Cornwall, we have one general hospital, but we are very fortunate that it is in the first phase of the programme because it is a women and children’s unit, which we have a desperate need for. It was originally promised by the former Prime Minister, Boris Johnson, more than 10 years ago, but nothing came to fruition. We have been waiting a long, long time for it.
I fully accept that government is about choices. We have had to deal with—whatever we want to say; however we want to position it—a number of different challenges since we came into government—
Dr Rupa Huq (in the Chair)
Order. The Clerk is frowning at me, because this is a bit long for an intervention.
Perran Moon
Does the hon. Member agree that we now have a coherent programme—however long it is for—to implement those changes?
Dr Mullan
That remains to be seen; we will have to see what the Office for Budget Responsibility says in March about the planned public expenditure limits.
To be clear about taking interventions, I am very happy to debate things, but this is a 30-minute debate in which the primary focus is on the person who secured the debate. The Minister will get a chance to make those repeated points, so I will not let anyone else make another intervention. I was happy to let people make interventions, because I am keen for you all to champion your local hospitals, but if you are not willing to play ball with me—
Medicines and Healthcare Products Regulatory Agency
Perran Moon Excerpts(1 year, 2 months ago)
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Perran Moon (Camborne and Redruth) (Lab)
I thank the right hon. Member for Tatton (Esther McVey) for securing a debate on what is an incredibly important campaign in support of the reforms to the MHRA. I would like to make clear my interest as an officer of the all-party parliamentary group on Primodos.
I will focus on the human case for reform. I would like to share part of a speech delivered at a recent APPG meeting by Jason Farrell, a journalist who has been instrumental in communicating the campaign for some time and who powerfully put into words the experience of Marie Lyon and other victims. He said:
“In October 1970, in Billinge maternity ward in Wigan, a woman gives birth to a girl. The baby is quickly rushed out of sight and later brought back swaddled. When Marie Lyon unwraps her daughter, she discovers half her baby’s arm is missing.
Meanwhile, in Portsmouth, Shirley Gubbins gives birth. Her daughter is so damaged, medics put her in a cupboard, assuming she will be dead within minutes. Shirley’s husband demands to see his child and discovers the baby’s back is twisted, her face disfigured, and one eye is missing. When she’s eventually allowed to see her baby, Shirley reacts in exactly the same way as Marie does: ‘She’s beautiful. She’s mine.’”
As a relatively new MP, I first met Marie Lyon, campaigner-in-chief and chairwoman of the Association for Children Damaged by Hormone Pregnancy Tests, just a few months ago at the request of a constituent. Marie has met many MPs in her years campaigning for recognition and justice for mothers and children affected by hormone pregnancy tests. I had not met many campaigners like her before, and I had certainly never met a leader with such reserves of stamina and such a profound sense of injustice.
I speak here on the shoulders of victims, families, activists, MPs, scientists and academics who have called for substantial reform of the MHRA and for the Government to acknowledge the harm done to patients and to implement the recommendations of the IMMDS. The harrowing stories of victims of this scandal after decades of fudges, obfuscation and inaction that have hindered their pursuit of justice must be heard again and again in the Chamber. The evidence is clear. The time for talk has long passed. It is time for us now to act.
NHS Dentistry: South-west
Perran Moon Excerpts(1 year, 4 months ago)
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Richard Foord
That is exactly what is needed for urgent and emergency care. My hon. Friend draws attention to Somerset; the situation is bleak in Devon too. In Devon in 2015, 55% of adults were able to see a dentist, but that has since dropped to just 37% today.
I have had so much correspondence from my constituents on this subject, and the decline, as I see it, is a direct result of 14 years of Conservative neglect of our health services and of NHS dentistry in particular. I find it really troubling that the situation is affecting people in some of the most vulnerable categories, such as older people and children,
Children in Devon are missing out on crucial dental check-ups. Once upon a time, they used to have check-ups twice a year; now, it is not possible for children to be registered for NHS dentistry in many dental practices. It is therefore no surprise that tooth decay is now the leading cause of hospital admissions for five to nine-year-olds in the country. I talked to one primary school and was told that pupils are going to hospital in Bristol to have their teeth removed—often between four and 10 teeth at a time. The number of NHS dentists in Devon has dropped from 549 to 497, so the reality is that NHS dentistry is simply no longer available for all.
Perran Moon (Camborne and Redruth) (Lab)
I entirely accept the points that have been made about Devon and Somerset. In Camborne, Redruth and Hayle, we have some of the most deprived areas in the country. I have met people who have chosen to access dental care privately at the expense of heating their homes or eating food. This is where we are today: we are in a dental emergency across the south-west, and in Cornwall, the situation is now critical. Does the hon. Gentleman agree that we cannot wait any longer for emergency dental care across the south-west?
Richard Foord
The hon. Gentleman is right. We want to move NHS treatment back into primary care and away from the most critical acute care, yet it seems to me that primary care services are moving in the other direction.