Covid Pandemic: Testing of Care Home Residents

Peter Bone Excerpts

Wednesday 1st March 2023 Commons Chamber

[Helen Whately]

The hon. Lady is right about the importance of testing. It is a view that she has and that I had at the time; some of the exchanges will show how I, as Social Care Minister, was arguing very hard for testing for care homes, as Members would expect. I know that other Ministers and other people were arguing for the things that they had oversight of. Ultimately, of course, the Health Secretary and the Prime Minister had to make decisions, based every step of the way, clearly, on the scientific advice on these things, as we did. To that point, during the course of the pandemic, as the capacity allowed, millions of tests were distributed to care homes. As I have said, as the capacity increased, care homes were prioritised in that process. Specifically to address one of the points she made, let me say that the guidance set out on 15 April was not only that everyone discharged from hospital to a care home should be tested, but that they should be isolated.

[Mr Peter Bone (Wellingborough) (Con)]

It seems that the Opposition want to rewrite history. The fact is that at the time people did not know what was right or what was wrong. The then Secretary of State listened to a whole lot of advice and then had to make a decision. Even one of the WhatsApp messages I have seen said:

“Tell me if I’m wrong”.

What should happen is that the covid inquiry should deal with all these matters properly. The one question I have for the Minister is this: is it possible to get the covid inquiry to report earlier?

[Helen Whately]

I completely agree with my hon. Friend about the covid inquiry being the right place for people to go through the details of what happened—who said what and, as he said, the genuine debates that took place behind the scenes. This was a new virus and, at the time, we had only limited information about it. For instance, when it first hit our shores, it was not known who would be most vulnerable to it. We also did not know about asymptomatic transmission. There was a huge amount of uncertainty at the time, but the best possible decisions were made. As for the timing of the public inquiry, that is not within the control of Ministers.

NHS Workforce Expansion

Peter Bone Excerpts

Tuesday 28th February 2023 Commons Chamber

[Wes Streeting]

I am glad that finally Government Members have noticed that Labour has got a plan and are asking how it will work; I wish that Government Ministers would join in. The proposal we set forward to double the number of medical school places is based on modelling put forward by the Royal College of Physicians, which understands perfectly well the points the hon. Member makes. I have had excellent meetings with university vice-chancellors, who are keen to roll up their sleeves and help. The reason we set out a plan this far from a general election was for two reasons. First, we want to give medical schools and NHS employers time to prepare for the expansion. Secondly, we hope that the Government adopt this plan to give the next Labour Government a head start. I very much hope, as this motion says, that the Chancellor will take our plan and incorporate it into his Budget, and I will cheer him if he does so.

I will tell the House how ludicrous the situation is today. There are medical schools in England today that are exclusively training international students, many of whom will leave upon graduating, while at the same time we are turning away thousands of straight-A students from our own country who want to help the NHS. Brunel University is training 100 new doctors, with not a single UK student. Chester University has deferred the launch of its medical degree by a year because the Treasury will not give it a penny. Local NHS trusts and charities have chipped in to fund 20 UK medical student places at Three Counties Medical School at Worcester University, because the Government are refusing to fund a single domestic student. Despite pleas from the NHS, the Minister for Skills, Apprenticeships and Higher Education, the right hon. Member for Harlow (Robert Halfon), has threatened to fine medical schools if they increase their offers to applicants next term.

[Mr Peter Bone (Wellingborough) (Con)]

rose—

[Wes Streeting]

I am almost certain that the hon. Member for Wellingborough (Mr Bone) will not agree with his universities Minister.

[Mr Bone]

The hon. Member is making an interesting speech. On the point about retaining people from overseas going into medical training, who he said will then qualify and leave, does he think there is an argument for having an arrangement of the sort they have in the airline industry, whereby someone who is trained here then has to work here for a certain number of years, or otherwise repay the cost? Does he think that would help the situation?

[Wes Streeting]

There are a couple of challenges with that approach. First—I want to be clear about this—having international students come to study at UK universities is a wonderful thing. It is wonderful for British students who mix with cohorts drawn from across the world, and it is wonderful because they contribute to the cultural and intellectual life of our universities, and of the towns and cities in which they live while studying here. It is a wonderful thing because they often return to their countries with fond memories of Britain, which is an extension of our soft power and diplomatic influence. Those are all great reasons why we should cherish, embrace and welcome international students, and it is why I hope the Home Secretary does not win the argument inside Government to restrict further access to international students. Finally, I should say that international students also pay an enormous amount to come and study here in the UK, and they subsidise home students.

I want to be clear about how much I welcome international students, but it is an absurdity that people are coming to this country to study in medical schools that have no British students. It is an absurdity, when we have a chronic shortage of doctors, nurses, midwives and allied health professionals, that we see straight-A students from our own country being turned away, while university medical schools are being told they can only recruit international students. That is the depths of stupidity that this Government are plumbing.

NHS Winter Pressures

Peter Bone Excerpts

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

On the interaction between vacancies and workforce, NHS England is working on a workforce strategy, as has been said, and we will say more on that shortly.

In his wider point, the hon. Gentleman is ignoring examples such as the Jean Bishop Integrated Care Centre—the ability to bring health sector and social care staff to work together in a more integrated way. Yes, the integrated care boards were operational from July. That is a factual statement; I am slightly mystified about why he thinks that was in some way an unusual observation to make. It is just the factual position. The point is that when one looks at the issue, one sees opportunities, particularly around how the data are better integrated, to understand where the workforce pressures and bed capacity are.

One of the causes of delayed discharge is about the interfaces as well as what is domiciliary care, what is step down and what is residential. There are a number of issues. By bringing them together in more integrated way, integrated care boards will be one of the ways we improve the situation. Indeed, that is what the hon. Gentleman’s former colleague Patricia Hewitt is looking at through the Hewitt review.

[Mr Peter Bone (Wellingborough) (Con)]

I am grateful to the Secretary of State for getting to grips with delayed discharges. As he will know, only a third of such discharges are in social care; most are down to the fact that there needs to be an NHS medical discharge.

I have some good news for the Secretary of State. The bad news is that Spinneyfields in my constituency, a 51-bed social care step-down facility, is going to be closed. If the Secretary of State spent a small proportion of the £250 million, the NHS could take over Spinneyfields and tomorrow 51 beds would be released at the acute hospitals in Northampton and Kettering. Will he agree to that now?

[Steve Barclay]

One of the things that my hon. Friend agrees with is that more decisions should be devolved rather than every decision being made in Westminster. Part of the reason for integrated care boards is so that they can look at where best to allocate their funds locally. He raises an extremely important point. He is right that around a quarter of delayed discharges are on the social care side—a fifth actually, in the NHS; there are a number of factors within that, which we will need to disaggregate.

On my hon. Friend’s point about local capacity, the Government are allocating the funding to his local ICB. I am sure he will have a conversation with his ICB on where the spare capacity can be best identified and rolled out at pace.

Oral Answers to Questions

Peter Bone Excerpts

Tuesday 6th December 2022 Commons Chamber

[Helen Whately]

The hon. Member makes a really important point. I will say two things. In the short term, we are supporting social care with £500 million through the discharge fund this winter. That will go into increasing capacity in social care and addressing some workforce challenges in areas such as his. In the long term, we are introducing social care reforms, including in the workforce. One thing we need to look at is ensuring that housing is available for the social care workforce.

[Mr Peter Bone (Wellingborough) (Con)]

I have listened to the Minister talk about increased social care, but I do not recognise that in my area. Northampton General Hospital, which is one of the hospitals that serves my constituency, has around 150 patients who could medically be discharged but cannot be. That accounts for 19% of the beds. At the same time, West Northamptonshire Council is closing Spinneyfields, a 51-bed step-down facility in my constituency, yet it has a private finance initiative contract and, for the next seven years, will pay £700,000 for an empty building. How can that be right? Will the Minister sort it out?

[Helen Whately]

I will take away that example from my hon. Friend’s constituency and look into it. I want to see increased capacity in step-down care and social care during this winter and beyond, but particularly during this winter, supported by the £500 million discharge fund. That will go to areas such as his and across the country to help to make sure that people who do not need to be in hospital can be out of it getting the care that they need.

--- Later in debate ---

[Mr Peter Bone (Wellingborough) (Con)]

Can the Secretary of State give the House an undertaking that no NHS or social care facility will be decommissioned and used to house asylum seekers in Northamptonshire or the rest of the country?

[Steve Barclay]

I am not aware of any proposal on those lines. On my hon. Friend’s earlier point, as I said, I am happy to meet him to discuss the issue of step-down care and I am sure that there will be an opportunity to discuss any other concerns that he has at the same time.

Covid-19: PPE Procurement

Peter Bone Excerpts

Thursday 24th November 2022 Commons Chamber

[Neil O'Brien]

Of course we take action whenever we find underperforming contracts, and I have set out how we do that. We are working our way through that. I say simply to the hon. Gentleman that we were all desperate to get PPE for our health and social care workers and for everybody who was responding to the pandemic. Inevitably, some of those contracts were not going to perform, and we are now taking action against all those underperforming contracts. On the idea that the “politically connected”, as he says, had some sort of greater success, they were our constituents—they were getting in touch with all of us, they had to be referred on somewhere, they had to be managed and they went through the same process as every other contract.

[Mr Peter Bone (Wellingborough) (Con)]

I think there is a little rewriting of history here. At one stage in the pandemic, getting PPE was the most important thing, and I remember Members on both sides demanding quicker action from the Government. The Minister has explained the situation fully, and I regret that the Opposition are making political points from what was actually a great success in protecting our NHS staff. Does the Minister agree with me or with that lot?

[Mr Speaker]

I suspect he might agree with the hon. Gentleman.

Government Action on Suicide Prevention

Peter Bone Excerpts

Wednesday 8th June 2022 Westminster Hall

[Sarah Olney (Richmond Park) (LD)]

It is a pleasure to serve under your chairmanship, Mr Bone. I pay tribute to the hon. Member for Bristol East (Kerry McCarthy) for securing this debate. I can see that the subject is really difficult for her to talk about and I thank her for sharing her experience. I was struck by what she said at the end about how it is the people left behind who take on the suffering. I have had a bit of an insight into what she talked about.

I have a constituent here today, Mr Philip Pirie, who I am glad has been able to join us; he is in the Public Gallery. Philip’s son Tom took his own life in July 2020. I have been working with Mr Pirie since then and talking to him about his experience of suicide and how it has impacted him and his wider family and Tom’s family and friends. Mr Pirie highlighted a particular issue in Tom’s experience, and I have been happy to work with him on a campaign. We have previously spoken to the Minister about it.

Tom was a schoolteacher. He loved to travel and spoke three languages. He was much loved by his friends and family. Subsequent to his death there was a memorial football match, which was held to commemorate him, between his former school and club teams. Tom did seek help for his mental health issues, and he spoke to a therapist just a day before he took his own life.

A troubling feature of Tom’s experience is that he was assessed by his counsellor, at that meeting the day before his death, as being at low risk of suicide. That is something that has caused Philip and the wider family a great deal of distress, because if Tom had not been deemed to be at low risk of suicide, more might have been done to save him. So Philip has taken up with me the issue of suicide risk assessments by counsellors and how they are being used. It is a big issue.

We heard from the hon. Member for Blaydon (Liz Twist) about the extent to which suicide is a public health issue. The thing that has struck me is that suicide is the most common cause of death among young people aged 20 to 34—that is how much of a risk it is to our young people. More than anything else, that is how they are losing their lives.

Of the 17 people who die by suicide every day in this country, five would have been in touch with mental health services. The hon. Member for Liverpool, Walton (Dan Carden) mentioned that that is not enough, because so many people do not seek help. Of the five who have been in touch with mental health services, four will have been assessed as at low or no risk, as we have seen Tom Pirie was. That raises questions as to how we assess suicide risk, and I would like the Minister to address that.

Mr Pirie and I have organised an open letter and had a wide range of signatories to it. These include Steve Mallen from the Zero Suicide Alliance, who has already been mentioned, Mind, Samaritans, Papyrus, General Sir Nick Carter—we were very privileged to have his engagement with us—and a cross-party selection of MPs. This is really about discussing the current suicide risk assessment procedure, because we think that it needs some serious and urgent attention. We think that the standardised risk assessment tools as they are currently being used are poor predictors of suicide, and national guidelines have determined that they should not be used for that purpose. There is widespread concern that risk assessment tools are being used ineffectively, and that it is leading to the outcomes that we have seen in the case of Tom Pirie and others. We think that suicide risk assessment tools have a positive predictive value of less than 5%, which potentially means that they are wrong more than 95% of the time.

In its “Self-harm and suicide in adults” report from July 2020—the month that Tom Pirie took his life—the Royal College of Psychiatrists stated that

“the current approach to risk assessment is fundamentally flawed.”

The Government published a suicide prevention strategy for England in 2012, and they have recently announced a review and issued a call for evidence. The National Suicide Prevention Advisory Group is preparing to issue its recommendations for the review of that strategy, and the letter asks that:

“The Secretary of State for Health and Social Care ensure that the new suicide prevention strategy includes a review of the use of suicide risk assessments in breach of current guidelines and to take appropriate steps to ensure that existing guidance around not using these tools to assess suicide risk be strictly followed by both the public and private health sectors.”

That is a really important point, because there is a lot of mental health support that happens outside the NHS. Informal and unqualified support can sometimes be provided, and it is really important that the public understand and can have faith in the kinds of people who are advertising their support services for mental health patients, and that there is guidance and regulation around what is available.

In 2007, the Department of Health published a document entitled, “Best Practice in Managing Risk”, which underpinned and gave approval to some suicide risk assessment procedures. That important document is relied on by a number of institutions, including the Care Quality Commission and the coroner service, but has not been updated since 2009. We would really like to see the Department of Health and Social Care commit to updating the document alongside the strategy review, to ensure that the best current guidance is available to mental health practitioners in all sectors, that there is appropriate use of suicide risk assessment tools, and that we do not see a repeat of the situation that happened to Tom Pirie, who was assessed as a low risk the very day before he took his own life. I learned, in speaking to Tom’s father Philip, that it gave Tom the sense that he was not being listened to, and that his concerns and troubles were not being taken seriously. Obviously we will never know, but that cannot have been a helpful indicator for him at that moment in his life.

I pay tribute to Philip, who has been incredibly brave, and I know this has been a very difficult time for him. I am here today to urge the Minister to take on board my asks around risk assessment tools, because it would be a great tribute not just to Tom, but to Philip and his wider family.

[Mr Peter Bone (in the Chair)]

It might be helpful to say that we have three Back Benchers trying to catch my eye. I have to start the wind-ups no later than 10.30 am, so each Member has six or seven minutes max.

Health and Social Care Leadership Review

Peter Bone Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

I agree with the hon. Gentleman. I know that he has a long-standing, valuable interest in this issue. I appreciate that he has not had time to look at the report, but I think he will be pleased when he reads our recommendations around a modern training plan.

[Mr Peter Bone (Wellingborough) (Con)]

The most important thing that happened in Westminster this week was yesterday’s reception for Harry’s Pledge. Harry is a young boy who needs a lot of care. Harry’s Pledge campaigns for the needs of carers and those who are cared for. I am introducing a private Member’s Bill to give guidance for that. Will the Secretary of State look at that Bill to see whether the Government could support it? Leaders in care need to have the guidance to judge whether they are succeeding.

[Sajid Javid]

This is a very important issue for my hon. Friend. I would be happy to meet him to discuss it further.

Oral Answers to Questions

Peter Bone Excerpts

Tuesday 19th April 2022 Commons Chamber

[Sajid Javid]

Integration between the NHS and social care requires the right level and quality of workforce, both in the NHS and in adult social care. In the NHS in England, we have more doctors and nurses—more people working than ever before. In adult social care, we are recruiting at high levels, not least because of the huge recruitment campaign we ran with the sector, and some of the other changes we made, including the £400 million- plus of retention funding over the winter period. In addition, the support for the workforce more generally is making a real difference.

[Mr Peter Bone (Wellingborough) (Con)]

In north Northamptonshire, integration is getting on very well, with Councillor Helen Harrison heading the adult social services. However, going back to what my hon. Friend the Member for Northampton South (Andrew Lewer) said, there is the worry that because the NHS is so big it will overwhelm local government. I have told the Secretary of State that they do not want to mess with Helen Harrison, but can he ensure that there is a mechanism for reviewing that?

[Sajid Javid]

I know that my hon. Friend knows Helen Harrison extremely well, but he is right to talk about the importance of the NHS and the adult social care sector and local authorities working together. We must make sure that it is a true partnership, where one does not overwhelm the other and they work together towards their shared interests.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I thank the hon. Lady for her question, and we have met to discuss this previously. I am happy to discuss with Health Education England whether one of its centres for dentist development could be suitable for her constituency.

[Mr Peter Bone (Wellingborough) (Con)]

T6. In 2019 Kettering General Hospital, which serves my constituency, was promised £46 million for a major upgrade. Three years later the hospital still has not got the money. Secretary of State, will you go out and buy a very big pair of scissors, cut through the red tape and get it sorted?

[The Minister for Health (Edward Argar)]

No one, with the possible exception of my hon. Friend the Member for Kettering (Mr Hollobone), is more passionate than my hon. Friend the Member for Wellingborough (Mr Bone) about seeing improvements delivered in their local hospital, and I had the pleasure of visiting. As my hon. Friend will know, the £46 million was allocated originally for an urgent treatment centre; the hospital asked that that be changed and it folded in with the overall programme. It has yet to submit a business case for the enabling works; when it does, I will make sure that it is expedited.

Elective Treatment

Peter Bone Excerpts

Tuesday 8th February 2022 Commons Chamber

[Sajid Javid]

I agree with the hon. Gentleman that all those working in health, and social care for that matter, have been the heroes of this pandemic. Everything that they have delivered and gone through over the last two years is something that the whole nation will respect. He is right to also point out that the expectation over the next few years for delivering on the plan is very high, and the workforce of course deserve maximum support. When it comes to pay, it is right that the Government listen to the independent pay review bodies, which will take into account a number of factors, and that is exactly what we did last year.

[Mr Peter Bone (Wellingborough) (Con)]

I am grateful to the Secretary of State for coming to the House and making this announcement here first. Does he agree that, as other Members have said, particularly Opposition Members, we need to increase the workforce? How then can the mandatory vaccination of NHS health workers, which was going to lose us 80,000 people, possibly have been right? We knew the covid backlog was there, so how on earth was that ever a good policy? I know that Opposition Members supported it hugely, but Conservative Members had their doubts. Was it not a wrong decision?

[Sajid Javid]

I agree with my hon. Friend about the importance of the workforce, but I am afraid I do not agree with his comments about the plans for mandatory vaccination. I will not go through the details again; I did make a statement to the House on that last week, and in fact it was supported by the vast majority of Members of this House. The short answer to his question is that it is all about patient safety. The Government and the NHS are always absolutely right to put patient safety first, and although the Government have now, in the light of omicron, rightly changed their plans, it is still the professional responsibility of everyone working in healthcare to get vaccinated.

Elective Care Recovery in England

Peter Bone Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

The hon. Lady raises an important point. I know that the House is grateful for her work on this important issue. She highlights the NICE guidelines, which are an important step forward. We continue to work with NHS England on how to most effectively ensure that patients with ME get the early diagnosis and treatment that they need. I or the relevant policy Minister will be happy to meet her to discuss progress and her and the APPG’s thoughts and ideas in that space.

[Mr Peter Bone (Wellingborough) (Con)]

The Minister is right in what he says again and again. I remember a few years ago, a close relative had liver cancer. They went to see the consultant and were given a one in three chance of surviving but managed to pull through. At the same time, another Government plan for the NHS was announced. I said, “What about that?”, and they said, “Well, we just ignore it, because they’ll change it again in a few years. What we actually do is get on and do best practice now.” I think what the Minister is saying is happening at the moment. What the Government could do in the plan is cut red tape in the NHS, which might speed up the construction of the hospital that we need in Kettering, which is so welcome.

[Edward Argar]

I am grateful to my hon. Friend not only for his well-timed plug for his local hospital in Kettering but for his important point. The NHS and the Government have been getting on with improving things and trying to bring service levels back to pre-pandemic levels. Notwithstanding his comment about plans more broadly, it is important for us to have a clear long-term strategic approach to it, because the sums of money involved are significant. The waiting lists and the impact on those are significant. It is right to ensure that we have a clear plan and clear metrics to show how that public money will deliver the outcomes that we all want to see delivered and that those patients want to see.