Oral Answers to Questions
Rachael Maskell Excerpts(3 weeks ago)
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Rachael Maskell (York Central) (Lab/Co-op)
Last Saturday night I had the opportunity to go out in York with the police. It was incredibly interesting and I am so grateful for the work that they do, and it gave me an opportunity to speak to employers. We know that, as employers, our traditional pubs are really struggling because the pubs code is not working properly. Will the Minister meet me and the Campaign for Pubs to discuss how we can improve things for those businesses?
Gareth Thomas
I will be very happy to meet my hon. Friend. I know from talking to pubs that they are also very worried about the rise in antisocial behaviour and crime in our high streets and town centres. She and the pubs and other members of the night-time economy that she works with will, I hope, be reassured by some of the measures that we have taken in the Budget to begin the process of cracking down on antisocial behaviour.
Budget Resolutions
Rachael Maskell Excerpts(8 months, 2 weeks ago)
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Rachael Maskell (York Central) (Lab/Co-op)
It is a pleasure to follow the hon. Member for Torbay (Kevin Foster). His constituency is a tourist destination, much like York. The hospitality and tourism sector certainly faces its challenges, and I look forward to studying the proposals from Government.
This clearly is the last Budget of this Parliament and, after today, this Government. They have had 14 years, and the Tories are leaving the country with record debt, public services on their knees and households floundering with the cost of living, high rents and mortgages, utility, food and fuel bills up. Rather than repairing the economy, which is now in recession, the Chancellor has forgotten how his predecessor crashed the economy and left the nation’s pensions hours away from collapse, and how it will take a generation to recover. Households are now £870 worse off under the Prime Minister’s tax plans.
The Government are extending the household support fund—I have long campaigned for that—but by just six months, when so many families in our constituencies are hanging by a thread. As a rich country, Britain should not need such measures, but when many people have so much, we see how entrenched inequality is. The very safety net that should keep people safe has been slashed, and people are falling through it. Nearly 4 million people are living in absolute destitution, with 1 million on universal credit requiring budgeting advances, as the Chancellor said. We hear what the Joseph Rowntree Foundation is saying. Its research shows that social security is simply not enough for the essentials; it needs to be paid at a rate of at least £120 a week for a single person or £200 for a couple. Scope has said that disabled people fare even worse and need an additional £12 a week to keep themselves afloat. Of course, the cap put in place so that people get support for only two children means that children are left in poverty, too. It should be scrapped.
There was nothing for local government, and that will be ringing in the ears of councillors up and down the land. The Local Government Association says that one in five councils are facing bankruptcy. Since 2015, the City of York Council has seen a 53% real-terms cut in its settlement. National Government are stripping local government.
Where is the housing we need, not least the social housing? Why are people still waiting to see an NHS doctor or dentist? Why are people left languishing on the wards of our hospitals? It is because they cannot get social care because people are not paid enough to do that job. Crime is up, the justice system is dysfunctional, our schools are squeezing their budgets and our youth services have more or less disappeared—cut by 87% in York.
The Government have squandered 14 years. The consequences of running the economy poorly are stark, as I turn to the world’s poorest. We think about those right now in Darfur and in Gaza, where there is no food, no medicine and no hope. Failed economics means that overseas development aid has been slashed and people are left hungry and sick. That is why we cannot afford this Government.
Do not get me wrong—some people are doing incredibly well. They have profited from dodgy personal protective equipment contracts and dodged tax altogether. Now that the Prime Minister is planning his exit from Parliament—and, no doubt, Britain as well—he is reforming the non-dom status from which he has personally benefited. After 14 years of virtually no productivity and bouts of recession and economic volatility, with working people’s heard-earned taxes gambled and burned, the Budget has proven that the Government have failed to put people above party.
It will be tough for Labour—our inheritance has been squandered—but we will stabilise, invest in and reform the economy. We must do so, rebuilding with fundamental Labour values that determine economic competence and stability and address the scourge of inequality. We will invest in future industries and jobs, innovations, entrepreneurs, and science and technology, not least on climate mitigation, with Great British Energy decarbonising the grid. We will double onshore wind, triple solar power and quadruple offshore wind, bringing down energy bills for the benefit of all.
I was greatly disappointed that York and North Yorkshire’s green new deal did not get a mention. It has the opportunity to create 4,000 green-collar jobs. BioYorkshire will be a game changer for our region and for the climate. We need to ensure that we elect David Skaith as Labour’s first Mayor for York and North Yorkshire, because he will bring that project to life.
As we reform, we need to bring about change. We need to build the houses that the next generation need and this generation are desperately crying out for. We need to retrofit millions more homes to secure green homes for the future.
There are a few things from today’s announcement that I welcome, including the funding for the National Railway Museum as it expands as the world’s largest rail museum. I encourage hon. Members to come and visit as it opens its new doors. I welcome the changes to taxation on short-term holiday lets following my campaign and private Member’s Bill to stop landlords flipping their homes, but reforms that would ensure the housing we need have not come forward. I am disappointed that the Government will give grandfathering rights to existing properties, meaning that 2,000 family homes in York will not be returned, or have the opportunity of being returned, to families who desperately need them.
I am interested in what the Government had to say about the £3.4 billion investment in the NHS following the Health and Social Care Committee’s report on digital transformation. I look forward to scrutinising the plans.
As we celebrate International Women’s Week, I must highlight that women are always losers under Tory Budgets. With childcare costs rising and social care collapsing, the burden falls on women. We need to see change. Our first Chancellor in the new Government will be a woman, and I encourage her to introduce gender budgeting, in which every decision is stress-tested to ensure that it levels women with men. Fiscal policies, political choices and administrative procedures must address gender inequality, so that the economic output of women is recognised and equality is achieved, and we get better economic stability, better growth and greater productivity gains. That is working elsewhere, and I want it introduced in the next Parliament.
Today, there will be headlines; tomorrow, reality will hit. We will not forget these last 14 years. With the general election on the horizon, and the prospect of an economic reset under Labour, we must move forward with Labour’s values, which we have held for 124 years, and use our common purpose for the common good.
Children’s Mental Health Week 2024
Rachael Maskell Excerpts(9 months, 3 weeks ago)
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Rachael Maskell (York Central) (Lab/Co-op)
It is a pleasure to serve with you in the Chair, Mr Pritchard. I congratulate my hon. Friend the Member for Tooting (Dr Allin-Khan) on securing the debate and on all the work that she has contributed in looking at mental health and, in particular today, children’s mental health.
I believe that no one has the monopoly of wisdom in this area—every day we are learning how to move forward—but key components need to be put in place. We know, and have heard in the debate, the role that trauma plays and its impact on children’s mental health. We also know that the environment to which a child is exposed can trigger and escalate the challenges they face.
We have heard about the shortfalls in the number of professionals required in the services. We need greater investment, not just through ringfenced and protected finance and funding, but to ensure that the NHS long-term workforce plan focuses on the mental health workforce that is needed now and into the future. As we have heard, whether workforce issues are due to the impact of covid or other factors, they will have a significant impact; and unless we make the right interventions early, there will clearly be consequences.
I particularly want to focus the Minister on the issue of leadership, because in an ever more complex health system—we have heard again today about the challenges of trying to navigate local authority and health systems—we need to have very clear leadership in this area. I urge the Minister to go back to the major conditions strategy and to pull out mental health, specifically looking at children and young people’s mental health, and to develop a 10-year strategy, not just for mental health in general as was originally planned, but for children and young people’s mental health, so that there can be not only a laser focus on the interventions that are needed but so the strategy can be held up to scrutiny, which is what this place needs to do.
I also urge the Minister to co-ordinate cross-departmental work to ensure that that strategy is robust and that the inter-relationships between different Departments work, because we recognise that the issues we are discussing today have impacts in so many different areas, whether we are talking about the environment, housing, poverty—as we have today—or indeed education. We need to ensure that we pull all that work together. I urge her to take that work forward and to respond to the debate.
In particular, I also want to focus on the intersections with children from the care sector—care-experienced young people—and the additional traumas that they have. Just last Thursday, we heard powerful evidence in this place when Adoption UK put forward its latest report, which discusses how the education system itself needs to change. I would be really interested to know what discussions the Minister is having with Education Ministers about creating a trauma-informed approach to schooling, particularly addressing some of the behaviour codes that are in place, and the processes of isolation and exclusions, which are bearing down on young people who, as we have already heard, have faced significant challenges since covid and before. It is incredibly important to ensure that such an approach is put in place, in particular for children with autism and children with attention deficit hyperactivity disorder, or ADHD.
Those children are having an adverse experience in the education system, which will be costly in the long term. There are too many children in that situation. I met an Education Minister this morning and highlighted the number of children who are not in school. We cannot just say that children are refusing to attend school with no reason and we also need to ensure that the school environment is safe for children.
I welcome the presence of health professionals in schools. I have to say that relying on teachers to lead on mental health in schools is the wrong approach, because teachers have so much to do already that they need back-up. Teachers are scared that they will miss something because they have not had the training that mental health professionals have. However, the roll-out of those teams of health professionals in schools is far, far too slow. I appreciate that there is a workforce challenge, but we need to expedite that work.
I will close by drawing attention to the work of Healthwatch York, which has really dug deep into children’s mental health issues in our city, and to the work that I have been doing and a recent meeting that I have had with parents from across our city. Systems seem to be impossible to navigate, there are long waits and ultimately services are overstretched and under-resourced. It is not just the young people themselves but their parents who need support, so I trust that the Minister will ensure that there is a parents strategy in all the work she does.
Oral Answers to Questions
Rachael Maskell Excerpts(10 months ago)
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Ms Ghani
The £28 billion that Labour is proposing has no plan behind it, and we are not told what hard workers across the country would have to pay to fill that black hole. Labour has asked for a transition to green steel. It would want us to protect steelworkers and obviously would want to protect advanced manufacturing in the UK. Customers want cleaner steel. Port Talbot could no longer function with its ageing blast furnaces, and our package will save 5,000 jobs at Port Talbot.
Rachael Maskell (York Central) (Lab/Co-op)
The Parliamentary Under-Secretary of State for Business and Trade (Kevin Hollinrake)
This week, I spoke to a conference attended by building societies about how we can increase presence on the high street to help with access to cash and finance facilities. The Government provide extensive business support to all businesses, including social enterprises and co-operatives. The British Business Bank’s recovery loan scheme and start-up loans improve access to finance to help those kinds of businesses to invest and grow.
Rachael Maskell
Co-operatives and social enterprise businesses provide a fairer way of doing business, involve members in greater business decisions and provide economic growth for local areas. However, they are being held back by financial and regulatory constraints. Will the Government match the Labour party’s and the Co-operative party’s ambition of committing to address those challenges and doubling the size of the co-operatives sector?
Kevin Hollinrake
Personally, I am a big fan of co-operative movements and the regional mutual bank system in Germany, which I have spoken about many times in this place. Of course, the Government supported the Co-operatives, Mutuals and Friendly Societies Act 2023, which helps to maintain the status of co-operatives. Social enterprises and co-operatives can also access support via the business support helpline as well as help through our websites and our network of local growth hubs.
Horizon: Compensation and Convictions
Rachael Maskell Excerpts(10 months, 2 weeks ago)
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Kevin Hollinrake
I agree that accountability is key. I think it is fair to say that my Department has learned lessons on governance. I spend a lot of time meeting the Post Office and, indeed, the Government’s representative on the Post Office board, UK Government Investments, to make sure that we have proper oversight of this arm’s length body. My hon. Friend is probably referring to something wider than the Post Office—other arm’s length bodies—and he raises a very important point to which we should certainly give consideration.
Rachael Maskell (York Central) (Lab/Co-op)
I understand how complicated it is to calculate compensation for individuals. My constituent’s numbers disappeared off their screen as transactions were being put through. Will the Minister ensure that more resources are put into supporting the process so that compensation can be paid more expediently?
Kevin Hollinrake
The hon. Lady is absolutely right. These are complex matters, and there are two ends to the compensation journey. One is the compilation of a claim by the claimant, which may include legal advice and assessments of health conditions, for example, so it can take time to compile a claim.
Under the GLO scheme, which is the most recent scheme, we have committed to responding to 90% of claims within 40 days. We believe we have the right level of resources at our end to make sure we can respond fairly and quickly. The assessments are made on the compensation side by independent individuals and panels. We think it is a good process and we think it is resourced properly but, of course, we will continue to give it proper oversight.
Elderly and Vulnerable People: Loneliness and Isolation
Rachael Maskell Excerpts(11 months, 3 weeks ago)
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Rachael Maskell (York Central) (Lab/Co-op)
It is a pleasure to see you in the Chair, Mr Sharma. I congratulate the hon. Member for St Ives (Derek Thomas) on opening today’s debate and focusing on the digital economy.
We must remember that digital can be used as a positive, as well as a negative, and we need to focus. As we move at an even greater pace into a new age of AI and so many other technologies, we need to make sure that they work for everyone. The inequality that has been driven through the digital sphere has really shown itself, particularly among more marginalised groups.
It is a pleasure to follow the hon. Member for Westmorland and Lonsdale (Tim Farron), who focused on public services that have been withdrawn. Many of those services, such as post office and rail services, were once in public ownership, and the Government could drive the opportunities to enable connectivity. I think particularly of Royal Mail and the opportunities that we have there, if we see it not as a business, but as a public service that serves communities and checks in on individuals who are elderly or isolated; we know that would make a significant difference.
I thank the organisations that contribute so much, both locally in our communities and nationally. Age UK, the Marmalade Trust, the Jo Cox Foundation—it is a real pleasure to see my hon. Friend the Member for Batley and Spen (Kim Leadbeater) here—and the Red Cross do phenomenal work. My local community group, York Neighbours, helps with one-off projects, ensures that there are regular phone calls to individuals, and arranges connectivity groups and outings.
I take issue with the point that the hon. Member for St Ives made about needing a new national strategy. We have a very comprehensive national strategy. In fact, it is exhausting to read, because it covers every single Department in detail. We have that as a background, but the question is whether it delivers and meets the needs of people in our communities. I think we need to take a different approach, and to bring it into a public health framework. We should look at how we can deliver more locally. Ultimately, we can talk about grand plans, but this is about delivery. We have the structure; we know the problems; we have identified the need; we understand the causes; and we have definitions. We need to move beyond that now.
Kim Leadbeater (Batley and Spen) (Lab)
I thank my hon. Friend for giving way and for securing this important debate. Does she agree that we have achieved a great deal in this place on the issue of loneliness and, crucially, that that has been on a cross-party basis? I am extremely proud of the work of the Jo Cox Commission on Loneliness, which resulted in the world’s first Minister for loneliness, my good friend the hon. Member for Chatham and Aylesford (Tracey Crouch), and the first cross-Government loneliness strategy, which my hon. Friend referred to. Does she agree that, whoever forms the next Government, we must ensure that this issue is kept firmly on the agenda? We need to ensure that it is embedded in all Departments and across all sectors. My hon. Friend rightly paid tribute to the voluntary sector, which does a lot of the heavy lifting around loneliness, but every sector has a role to play. Will she also join me, as I hope everybody else in the House will, at the Tackling Loneliness Together festive fair at 2 pm next Monday in the Attlee Suite?
Rachael Maskell
I am grateful to my hon. Friend, who never misses an opportunity. I pay tribute not only to the incredible work she does in this place, but to Jo, who put this agenda on all our radars and did a phenomenal piece of work in raising its importance.
Another major point I want to make is about the interventions that we need—I have been reading a speech I made in this place two and a half years ago, and it feels like we have not moved the framework forward since that time. Recently, in the Health and Social Care Committee, we had some incredible witnesses, who talked about dealing with suicide among men, although there is a lot of cut-across and move-across. I was struck by a piece of data we were given showing that 45% of males who take their own lives live alone. That really brings out the pain and the isolation. People have not asked questions, so others are left very much in the margins.
Young people are now the group who experience the most loneliness in our society. What are schools doing to intervene and ensure that there is good socialisation? Children are so stressed at the moment because they are having to meet the requirements set down by the state, but are they confident individuals who can make social connections? How do we facilitate that to help them to navigate the ever more complex world in which they are growing up?
What about the GP and every other connection, such as the Department for Work and Pensions, for those who need support—not least the disabled people in our communities? What about local authorities? If a question was asked in every interaction to find out whether people were experiencing loneliness or isolation, we could start to put strategies in place to address those needs.
There is a real need to look at statutory services and to ask how we can build a framework, but also to look at what is happening across society. As we get older, these issues get more difficult. As we have heard, there are 7.8 million people on waiting lists. People are frailer and they get more withdrawn and isolated from communities and society, so it is harder and takes more effort to make those connections. It is important that we really look into that to find out not only the scale of what is happening locally and to ask those difficult questions, but to provide the necessary services, and particularly youth services. There used to be luncheon clubs for older people, but they have just gone. The funding crisis in local authorities is making things even more difficult, so my third request is that we invest in a public health strategy that enables pilot projects to move forward and to make those connections once again.
Draft Code of Practice on Reasonable Steps to be taken by a Trade Union (Minimum Service Levels)
Rachael Maskell Excerpts(12 months ago)
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Kevin Hollinrake
We did not think it necessary to develop a statutory code of practice for employers, but we are producing guidance for employers on how they can comply with their regulations and engage with their workforce in such situations.
To comply with section 234E of the 1992 Act, which was inserted by the 2023 Act, trade unions should take reasonable steps to ensure that their members who are identified in a work notice comply with that notice and do not take strike action during the periods in which the work notice requires them to work.
Rachael Maskell (York Central) (Lab/Co-op)
How will the employer be compliant with GDPR requirements in a multi-union environment where lists will be going to different unions and where the employer itself will not know which unions individuals belong to? How will the Minister ensure that the names of employees will not go to unions that do not organise those particular workers?
Kevin Hollinrake
The hon. Lady may be confusing two things. The employer and the unions both have a legitimate interest in the individual they are speaking to. The employer must speak to their workforce, and I am sure the unions will speak to their members. But this is all set out in both the statutory code of practice and guidance for employers. She will see more when she sees the guidance for employers.
Rachael Maskell
I am specifically talking about a multi-union environment. Where a number of trade unions are involved, how will the Minister ensure that GDPR requirements are met?
Kevin Hollinrake
It is not my responsibility to make sure that GDPR requirements are met.
Chris Stephens
That may very well be the case. The hon. Member makes an eloquent point.
Rachael Maskell
Every single day this Government are in office, they are unable to maintain minimum service levels across a vast array of our public services, so why does the hon. Gentleman think they are requiring more workers to attend work on strike days than the rest of the year?
Chris Stephens
That is a magnificent point. This has been debated on various occasions on which we have asked the Government—perhaps the Minister will rise to his feet; I will take his intervention right now—why minimum service levels are necessary on industrial action days, but not at any other time. If there were statutory guidance and a code of practice for employers, one would certainly ask the question: would employers demand that there be more workers on shift on days of industrial action than on a normal working day? The Minister knows this, because it has been raised consistently when we discuss these things that employers are always at it.
I was a proud trade union activist. I refer to my entry in the Register of Members’ Financial Interests: I am a proud member of the Glasgow city branch of Unison. We had to negotiate life-and-limb cover for strike days—yes, the legislation sets out that there has to be life-and-limb cover—and employers would ask for more people on shift on days of industrial action than on normal working days. I will take an intervention right now if the Minister can give us an assurance that no employer across these islands will ask more workers to be at work on days of industrial action than on normal working days. I am more than happy to take an intervention from the Minister right now.
I note for the record that the Minister has not risen to his feet.
Since the passage of the anti-strike Act, there have been suggestions that the Act’s provisions on minimum service levels would be similar to the norms of Europe. Well, no, they are not. I will not repeat all the clarifications that I and others have offered on what actually happens in Europe, as those fell on deaf ears. I will, however, repeat our warnings that this nasty legislation will prove to be severely counterproductive and damaging overall to society. Taking a negotiated, voluntary and successful approach to minimal service levels and mutating it into an imposed, coercive and ultimately failed system is very foolish, but it is unsurprising from those who choose not to listen or learn.
Let me comment in detail on one sector in particular: the health sector. I will do so by referring extensively to the TUC’s consultation response on minimum service levels for hospital services. I will also refer to the views of the British Medical Association and the Royal College of Nursing.
The TUC believes that the Act
“is unfair, undemocratic and likely in breach of our international legal commitments.”
Its view is that it is
“the fundamental right of a worker to take industrial action to defend their pay and conditions”
and that
“secretaries of state are to be given enormous power to define and introduce minimum service requirements”.
It says the Act is
“draconian: it could lead to individual workers being sacked for taking part in industrial action that was supported in a democratic process”,
with trade unions facing large damages if deemed to be non-compliant with this code of practice. Perhaps the Minister will answer the question with which he was challenged by the shadow Minister, the hon. Member for Ellesmere Port and Neston. The Minister was quoted as saying that no one would be dismissed as a result of this legislation, but where does it say that?
According to the TUC, the Act is “unnecessary”—it is “custom and practice” to agree “life-and-limb cover”—and “counter-productive”. That, however, is not the view of only the TUC, which points out that the Government’s own impact assessment suggests that
“industrial disputes are likely to become more protracted and prolonged as a result of introducing minimum service levels”.
In summary, the TUC believes the approach is unacceptable, anti-democratic, draconian and, ultimately, both unnecessary and counterproductive.
Given the purpose of this Delegated Legislation Committee, a further quote from the TUC might prove to be the undoing of the code of practice:
“Given the fact that the services subject to MSLs are to be determined by Secondary Legislation, there remains a number of uncertainties around (a) the extent to which the policy would restrict the right to strike, (b) the relationship between the ability to strike and the strength of workers’ ability to bargain on terms and conditions of employment through collective bargaining, and (c) the value workers place on collective bargaining relating to terms and conditions of employment.”
Those comments are also derived from the Government’s impact assessment.
Conservative Members may simply choose to disregard the findings of such an impact assessment. They would find interesting backers in doing so, as the Government’s own Regulatory Policy Committee judged the impact assessment of the Act
“red-rated as not fit-for-purpose”,
and found that the Government make
“use of assumptions in the analysis which are not supported by evidence”—
here is us thinking that the Boris Johnson days were gone. There are other, less parliamentary ways to describe making use of assumptions that are not supported by the evidence, which I will leave to the imagination of Members.
Let us now explore the views of the British Medical Association and the Royal College of Nursing. Agreement among health sector unions is clear, as the BMA also considers the proposals for minimum strike levels to be
“counterproductive, undemocratic, unworkable, and draconian”.
The legislation seems to be little more than a smokescreen. Instead of addressing the state of the NHS, which currently compromises patient safety on a daily basis, or the underlying reasons why doctors and other healthcare staff have been striking in some parts of the UK, if not in others, the Government are trying to paint healthcare workers as the villains of the piece, rather than the victims of governmental action and inaction. I specifically mention striking “in some parts of the UK,” because a different and more respectful approach to public service employees in Scotland has resulted in something closer to industrial harmony. Perhaps others should watch and learn from what the Scottish Government are achieving in public sector relations.
Throughout these islands, a long-standing history of constructive joint working between NHS employers and trade unions at a local level has patient safety at its heart. The introduction of minimum service levels in hospitals would poison those industrial relations. It would replace a system under which those who understand the local situation tailor their response to the needs of hospital service users with a national service level mandated from Whitehall and designed by those who arrogantly assume that they know better.
Although the Government’s consultation seemed to find that several critical incidents arose due to strike action, data from a freedom of information request suggests otherwise. It is unclear whether any were a direct result of action being called. Rather than demonstrating that patient safety was compromised due to industrial action, the data shows the importance of tackling the stresses that the NHS faces on a daily basis.
The BMA has repeatedly raised concerns that the “reasonable steps” that unions would be required to take to comply with the Act would force unions to act in a way that undermines their responsibility to represent their members. It is not “reasonable” to expect unions to take any steps that would undermine legitimate strike action, for which they will have passed a high threshold to have a lawful mandate under trade union legislation.
Rachael Maskell
Thank you, Ms Nokes; I will keep my comments incredibly short. I refer to my declaration in the Register of Members’ Financial Interests.
I am completely shocked and baffled as to why the Minister has brought forward these provisions today when he does not even understand the context of the impact that this will have on a multi-union workplace and the breaches of the GDPR that the employer will be subject to in sharing sensitive information about their employees with different trade unions. They will be able then to identify the people who are members of other trade unions. Therefore there will be a complete breach, which will clearly be challengeable in the courts. [Interruption.] The Minister shakes his head, but that will be the consequence.
I am also completely baffled in relation to the timetable. When it comes to balloting for industrial action, it takes months to organise an industrial action ballot. We are talking about complex public sector ballots on the whole. As a result, it is important to get the information accurate and permissible under the law. However, an anti-union employer will have only four days in which to provide the information to a trade union, and then it will be a case of cross-matching, getting a notice out by post, because obviously the union does not need to collect information on the email addresses of its members, and then giving the notification. It is an employer who has the responsibility for whether a worker goes to work or not. I say to the Minister that that obligation should not be placed on trade unions.
The Minister has not said what will happen to the worker’s protection if the worker does not receive the notice, and whether their protections will be removed and, as a result, they could end up with a dismissal, with no right of restitution at all. It is really important that the Minister brings clarity as to what will happen in those circumstances and, indeed, what will happen to the trade union if it makes efforts to comply with the legislation but is unable to do so because of the format and the way the data is provided. The Minister makes a lot of assumptions that the employer knows their workforces and who will be taking industrial action or not. I have to inform him that that is often not the case in these complex industrial environments.
The Minister is above this. I think the fact that he has brought this measure forward today just shows that he has not taken the time to understand the way industrial action ballots actually work and the consequences of this legislation.
World Sepsis Day
Rachael Maskell Excerpts(1 year, 2 months ago)
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Christina Rees
I agree with the hon. Gentleman. He must have seen my speech, because he has quoted some of the stats that I am going to come on to later.
What is sepsis? It is a life-threatening condition that arises when the body’s response to infection causes injury to its tissues and organs. It is a global health concern, but today I will focus on its prevalence, the challenges and some potential solutions in the UK. Sepsis is indiscriminate. While it primarily affects very young children and older adults and is more common in people with underlying health conditions, it can readily occur in those who are otherwise fit and healthy.
Sepsis can be triggered by an infection, including chest and urinary tract infections. It is not known why some people develop sepsis in response to those common infections whereas others do not. Sepsis is often referred to as “the silent killer” because of its ability to strike swiftly and unexpectedly. In the UK, sepsis is a significant public health problem. Each year around 240,000 cases are reported, leading to more than 48,000 deaths.
Sepsis is the leading cause of avoidable death in the UK, claiming more lives than breast, bowel and prostate cancer combined. Unlike data for heart attacks, strokes and cancer, sepsis data is imprecise, because it relies on coded administrative data rather than the granular clinical data of patient-level registries. Moreover, this striking deficit means that not only do we find it necessary to estimate the burden of disease, but we are decades away from precision medicine for sepsis. However, therein lies a paradox, as the UK’s unique healthcare infrastructure means that we are well placed to change that for the world.
Around 40% of people who develop sepsis are estimated to suffer physical, cognitive and/or psychological after-effects. For most people, those will only last a few weeks, but others can face a long road to recovery and develop post-sepsis syndrome. One of the biggest challenges in tackling sepsis is early diagnosis. Sepsis can mimic other common illnesses, making it difficult to spot in its early stages. Symptoms such as fever, increased heart rate, rapid breathing, confusion and extreme pain can be attributed to various conditions. This leads to delayed treatment, which significantly worsens the patient’s chance of survival.
To combat sepsis effectively, awareness is the key. The UK and devolved Governments, healthcare professionals, and organisations such as the UK Sepsis Trust have been working tirelessly to educate the public and healthcare providers about the signs and symptoms of sepsis. Public awareness campaigns and training for healthcare workers have been instrumental in improving early detection. Timely intervention is crucial in sepsis management. The UK Sepsis Trust’s “Sepsis 6” care bundle and treatment pathway includes administering antibiotics, providing fluids and monitoring vital signs, and has been implemented in 96% of hospitals across the UK and in 37 other countries worldwide to ensure rapid and effective treatment. Early recognition and swift action can save lives and reduce the severity of sepsis-related complications, but despite such work, there remain many cases of avoidable death every year.
Rachael Maskell (York Central) (Lab/Co-op)
I am grateful to my hon. Friend for securing today’s debate, and for the very powerful speech she is making. My constituent, a teenager, tragically lost his life. Not only did he display so many signs, his parents were screaming for help, but those calls for help—for further investigation and better treatment and management—were just not heeded. Does my hon. Friend agree that it is now crucial that we introduce Martha’s law, so that parents can be granted a second opinion when they ask for one, in order to save lives?
Christina Rees
I am very grateful for my hon. Friend’s intervention. I think she must have been looking over my shoulder, because I am just about to come on to Martha’s law. As always, her timing is impeccable.
Over the past couple of weeks, significant media attention has been given to the tragic case of Martha Mills, who died of sepsis aged 13. Martha’s grieving parents have advocated for the establishment of Martha’s rule, which would empower patients to request an immediate second opinion if they feel that their medical concerns are not being addressed adequately. Other preventable deaths include UK Sepsis Trust ambassador Melissa Mead’s son William. The then Health Secretary, the right hon. Member for South West Surrey (Jeremy Hunt), apologised to William’s family after a report found that clinicians missed four opportunities to save his life, and to Jason Watkins, who lost his daughter Maude when she was only two and a half years old.
In order to end these preventable deaths, parents need to feel empowered to advocate for their child—to just ask, “Could it be sepsis?”—and clinicians must be given clear guidance on the appropriate care pathway in cases of suspected sepsis. At the moment, there is room for improvement on the clinical side, because of the confusion created by delays in updating the National Institute for Health and Care Excellence clinical sepsis guideline, NICE guideline 51. In addition, research plays a pivotal role in understanding sepsis better and developing more effective treatments. The UK has a rich history of medical research, and ongoing studies are dedicated to improving our understanding of sepsis. Advances in genomics, microbiology and immunology are shedding light on the complexities of sepsis, paving the way for innovative therapies. Technology is also proving to be a game-changer in the fight against sepsis, with AI-powered algorithms being used to interpret patient data and identify sepsis risk factors early on.
The UK Sepsis Trust is a charity founded by an NHS consultant, Dr Ron Daniels BEM, in 2012. It has led the fight against sepsis after Ron witnessed the tragic and preventable death of Jem Abbots, a 37-year-old father of two. The UK Sepsis Trust aims to end preventable deaths from sepsis and improve outcomes for sepsis survivors. It also strives to raise public awareness of sepsis and works to support anyone affected by this devastating condition with its free, nurse-led support service. It raises awareness by educating healthcare professionals and by instigating political change.
The UK Sepsis Trust aims to protect people by enabling the prevention of severe infection and the treatment of sepsis, while helping to ensure that antibiotics are used responsibly. Its clinical tools are used by healthcare professionals across the country and have been formally endorsed by NICE.
The trust contributed to feedback on a draft update to the NICE clinical sepsis guideline—NG51—in March this year. The final version was due to be released in June, following a request by NHS England to update it in the wake of a statement from the Academy of Medical Royal Colleges about the timing of using antibiotics. However, the publication was pulled at the last minute without any obvious reason. The result is that we are left with a NICE guideline from 2016 that conflicts with the position statement from the Academy of Medical Royal Colleges. This has caused confusion among clinicians, which could lead to patient harm.
The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
It is a pleasure to serve under your chairmanship, Ms Fovargue. I start by thanking the hon. Member for Neath (Christina Rees) for introducing this important debate, which is taking place on World Sepsis Day; for her work as chair of the all-party parliamentary group; and especially for her tribute to Dame Cheryl Gillan, who did so much work in this space. I am sure that Dame Cheryl would have been delighted by the way the all-party parliamentary group has been taken forward under the leadership of the hon. Lady.
I was touched by how she shared her personal experience of sepsis because I think that will highlight to people listening or watching how difficult it sometimes is to diagnose sepsis and the very many circumstances in which sepsis can present. Sepsis is a devastating condition and, while many people who develop sepsis survive, every death is tragic. Patients rightly expect it to be recognised and treated promptly because very often they are feeling so poorly that they are not necessarily in a position to raise concerns themselves. Even as the hon. Member for Neath pointed out, just becoming unwell with sepsis has long-term consequences and it can take many months to recover from an episode. She put that extremely eloquently.
The many interventions have moved us all. Many of us will know people who have become worryingly ill or have died from sepsis. It is especially heartbreaking when the family of someone who has died from sepsis feel that more could have been done to save them. Those cases are hard to hear, but it is important for us to listen and learn at all levels of Government, from officials through to frontline clinical staff.
As has been mentioned, we have all been moved to hear about Martha Mills who was 13 when she tragically died from sepsis despite concerns being raised by her family about her care. On what would have been Martha’s 16th birthday last week, her mother spoke about her death and the need for patients and families to be listened to when they think that something is wrong. I echo the words of the hon. Member for Neath. We need to encourage more people to ask that question: could it be sepsis?
I am pleased to add my support to the announcement made by the Health Secretary that the NHS will be exploring the introduction of Martha’s rule in the United Kingdom. The Secretary of State is meeting Martha’s family later today and is looking at how this could be implemented. I am sure he will be updating the House and I am happy to update Members on the follow-up from that meeting and the work that is being done to look at this.
We anticipate that Martha’s rule will be similar to a system in Queensland, Australia, known as Ryan’s rule, which is a three-step process allowing patients and families to request a clinical review of a patient’s condition if they are deteriorating. Such a system would build on initiatives already being tested in the UK, including the Call 4 Concern scheme introduced in the Royal Berkshire Hospital. Evidence from the scheme suggests that patients and their families find it useful, and that it can make a real difference in outcomes for patient care.
Rachael Maskell
In the light of the fact that people suffering from sepsis can rapidly deteriorate, will the Minister ensure that a review of a patient could also be undertaken really quickly, without it becoming a bureaucratic process?
Maria Caulfield
Absolutely. That is the point: if families want a review, it needs to be done as quickly as possible. If we are going to look at Martha’s law, those processes will need to be looked at. It must not become bureaucratic to make a request. It must be a really practical process that makes a difference.
Sepsis is not a single disease and it cannot be diagnosed with a single test. It varies in presentation depending on the source of infection and the individual. I pay tribute to the UK Sepsis Trust, which today has reiterated the signs and symptoms for people to look out for, including: fatigue; not passing urine; breathlessness; skin being discoloured, which is particularly important for ethnically diverse communities, because the skin colour may be different in different communities; fits and shakes; confusion; and shivers. All those symptoms are signs of potential sepsis, so it is really important that people understand to look out for them. We will never fully eliminate the risk of sepsis or other forms of acute deterioration, but we must do everything we can to ensure that clinicians and other NHS staff working on the frontline can recognise a very sick patient.
As many Members know, 100% of ambulance trusts and 99% of acute trusts in England screen for sepsis using the national early warning score or NEW score, which is carried out in clinical care. Following recommendations from the Academy of Medical Royal Colleges and the National Institute of Health and Care Excellence, we are working to update national guidance on sepsis. I very much take the point made by the hon. Member for Neath about the importance of ensuring that that information is all in step and aligned with guidance across the board, so that there is one clear narrative about recognition of sepsis and the targeted use of appropriate treatment.
Research is key to improving outcomes the detection of sepsis and finding more effective treatments. We are committed to driving the evidence base to improve our understanding, and the Department is providing funding of over £1 billion a year through the National Institute of Health and Care Research to drive forward research studies in these areas. Since 2017, the national institute has funded 14 research projects on sepsis, with a combined total funding value of £27 million, but further applications will be welcomed, so if there people out there want to undertake research studies, please encourage them to come forward and put in applications.
It is important that I touch on antimicrobial resistance, as the issue is inextricably linked to sepsis. It is critical that we conserve our antibiotics so that if an infection occurs, they remain as effective as possible when they are really needed, including for sepsis. In line with the asks of the declaration, the Government are delivering a five-year national action plan and a 20-year vision to contain and control antimicrobial resistance by 2040.
I am pleased to say that we are working collectively, across the UK, with our counterparts in Northern Ireland, Scotland and Wales on that antimicrobial resistance national action plan. Hon. Members have touched on international collaboration, because no country or Government can tackle this issue alone. A study published last year by the Global Research on Antimicrobial Resistance Project shows that resistance was associated with the deaths of 4.95 million people worldwide, and many of those cases will be because of sepsis related to antimicrobial resistance. By working together with international partners, we can protect ourselves and help to treat sepsis more quickly and easily.
World Sepsis Day is an important reminder that there is more work to be done. In recognition of that and as a reminder of the importance of the issue, the Department is lit up in pink today. Once again, I thank the hon. Member for Neath. I am happy to meet her and anyone she wants to bring with her, because there is still work to be done. We have made great progress, and she is touched on work that is being done, including on Martha’s rule, but I am happy to meet her and the APPG to ensure that, by next World Sepsis Day, we have made further progress with this significant condition.
Question put and agreed to.
Non-disclosure Agreements in the Workplace
Rachael Maskell Excerpts(1 year, 2 months ago)
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Rachael Maskell (York Central) (Lab/Co-op)
It is a pleasure to serve under your leadership, Ms Ali. I congratulate the right hon. Member for Basingstoke (Dame Maria Miller) on eloquently opening the debate and making all the pertinent points as to why NDAs should be outlawed. It is very evident from what we have heard so far how they are used to hide discrimination and bad practice in the workplace. That is why I fully support her proposal and all the comments made across the Floor today.
I think we have learned, particularly in the last week, that creating secrecy in the workplace creates closed cultures and they can be incredibly dangerous environments. We heard yesterday in a debate in the main Chamber about seven consultants who blew the whistle. It would have been so easy to have silenced them with an NDA, and we have seen that right across the NHS. I will bring to this debate my experience from the health service, but also as a trade union official for many years, as to how NDAs have been used to silence people who are raising a concern and trying to speak truth to power, because ultimately this is all about power and control, and therefore we need to ensure that justice can be served in every environment and particularly in the workplace. We know that many people forced to sign NDAs are being forced out of organisations because they have had the nerve to raise concerns about what they have seen around them in order to make the work environment safer for themselves and others. They have shared those observations to see improvements in their organisation. It is not vexatious to raise concerns; it is the right thing to do and it should be encouraged. Not having laws to protect those individuals exposes them and brings about further risk.
As the Minister will know, I am bringing forward a Bill about bullying in the workplace and the cultures developed there—cultures of secrecy and of bad conduct and behaviour. There is certainly much to be done. Those people who experience the signing of an NDA are seeing a slamming of the door on not only their career but often their lives, leading to serious mental health challenges for many years. They have to live with the injustice they have been served for what is often a small sum of money to pay them off and buy that silence. We have to create open work places where we can have honesty, and raise concerns and see them resolved. Without that, we will enforce the negative cultures that we see in work practices today.
I refer to my entry in the Register of Members’ Interests—I should have said that earlier. When I was a union official, I saw many times how compromise agreements were a cheap option to try to buy people off, to move an issue sideways and to protect the perpetrator in the workplace. Even if people brought a case to an employment tribunal, a COT3 agreement would often be signed to bring a case to a conclusion. We have to look at that within the system as well. The purpose of such agreements is merely to shut down debate and move on, leaving a legacy for other people—the discrimination, poor conduct, assaults, harassment or discrimination that have already been experienced.
We should create an open culture so that no one fears raising concerns and people know they are working in a safe environment. A closed environment, as we have known in many contexts, is an unsafe environment. What we are discussing would make workplaces safer for everyone, not least those people who have experienced the most pernicious assaults as a result of the NDA process.
I look at what has happened across University Hospital Birmingham, where silence has been bought off individuals, and at the mental health trusts. There are questions across the piece at the moment about what is going on in those organisations, which are often very closed cultures in themselves. When concern is raised, individuals are invariably on sick leave as a result of the response that they get, and then they are bought—told that they cannot return, or their sickness brings them to that point. When someone is so weak and powerless because of what the organisation has done to their voice and agency, they will take a little scrap to try and rebuild and move forward.
Whether it is in healthcare, local government—we know it happens there—education or the police and justice system, we know that the issue is pretty prevalent. I ask the Minister: where is the data and the scrutiny over what is happening? Do we know the reasons why all those NDAs have been signed? Do we know the numbers in every sector? Do we know which employers are the perpetrators issuing NDAs? We need the data to legislate and to understand, but also to call out those employers using NDAs as part of their suite of employment policies. I also ask the Minister to dig deep into all sectors—not only the private sector, but the charitable sector and what goes on there. Some of the statistics may well surprise him.
We have to understand that the issue is about the impact on individuals as well as organisations. The right hon. Member for Basingstoke made a powerful point about the cost to organisations of being able to mismanage their staff in such a catastrophic way, but we also have to realise that that has an impact on not only the individual but their colleagues as well. Ultimately, it silences them, because they know what is coming next: their job will be on the line, and they will be managed out of the organisation one way or another.
This closed-culture mentality must be prised open by the Government and we must do everything we can. We are in a space where organisations fear the reputational damage and fear what is happening at the moment. Let us get the data and the legislation in place to ensure that we are not only tackling poor conduct but advancing good conduct in the workplace, so that every worker can be safe.
Several hon. Members rose—
Strikes (Minimum Service Levels) Bill
Rachael Maskell ExcerptsMonday 17th July 2023
(1 year, 4 months ago)
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Rachael Maskell (York Central) (Lab/Co-op)
Will the Minister spell out exactly how trade unions are to comply with and enforce a code that is outwith their jurisdictions in making workers go into work?
Kevin Hollinrake
The code of practice will be consulted on so that all parties are clear about what the obligations of the unions will be. We expect them to be quite straightforward. They have been debated at length, along with various ideas about how this might operate.
Kevin Hollinrake
I want to end my speech shortly, but I will give the hon. Lady one last chance to intervene.
Rachael Maskell
As has been pointed out on numerous occasions, the measures that the Minister is trying to introduce are outside the jurisdictions of trade unions, which therefore do not have the powers to implement them.
Kevin Hollinrake
As I have said, we intend to consult with all parties to make sure that they have a chance to comment on what reasonable obligations a union might be required to take. I think that it is pretty straightforward, and, indeed, unions will be familiar with the code of practice on picketing that was issued under section 203 of the 1992 Act. This code will be subject to statutory consultation, including consultation with ACAS, and to the approval of Parliament. The consultation will give trade unions, employers and any other interested parties an opportunity to contribute to practical guidance on the steps that a union must take in order to make it as practicable, durable and effective as possible.
Justin Madders
That is a very good question. My understanding—no doubt the Minister can correct me if I am wrong—is that it is still up to the employer to determine what work notices it issues, which makes the Bill a little ludicrous.
All these consultation papers, all these impact assessments, and we are still legislating in the dark.
Rachael Maskell
My hon. Friend has just made a valid point, because when NHS Employers and the NHS Confederation came before the Select Committee on Health and Social Care, they said that they did not want any of this legislation. Presumably, following that logic, they will not have to issue minimum service level terms for a strike.
Justin Madders
I thank my hon. Friend for her intervention. That is why it would have been so interesting to see what the consultation responses were to the draft regulations, because those might have told us whether employers were saying, “Don’t do this; we don’t think it is going to work.” We know that a long list of employers’ organisations are opposed to this Bill, and I will come on to that in a moment. They understand that, ultimately, it is not going to help industrial relations but will sour them.
In summary, the Bill’s impact assessment turns up late and is inadequate; no pre-legislative scrutiny or evidence sessions for the Bill took place; the Committee stage is rushed through in one day; and subsequent consultations are incomplete and leave many questions unanswered. Yet the Government still say that this Lords amendment is not necessary. The evidence to date and the opinion of the ILO say otherwise. I referred to the fact that the ILO is not alone in expressing concerns about the Bill. Many organisations have expressed alarm, including the Equality and Human Rights Commission, the Joint Committee on Human Rights, NHS Providers, the rail industry, the Chartered Institute of Personnel and Development, the TUC, and the Welsh and Scottish Governments. The Transport Secretary and the Education Secretary have also done so, and I could give more names, but I have only an hour for this debate and so I will leave it there.
When we have the shameful spectacle of the ILO calling this Bill out, Members need to think again. By rejecting this Lords amendment, the Government are, in effect, saying one of two things: either they do not know whether they break international law; or they do know but they just do not care. We ought to care, we ought not to be trailing behind in workplace protections, and we ought not to be mentioned in the same breath as Turkmenistan. We ought to be leading from the front, as an exemplar for other countries to follow and a leader on the international stage that says, “Yes, good workplace rights and strong trade unions are a key component in any prospering modem economy, and the right to withdraw your labour is a fundamental one.” However, this Bill is the hallmark of a weak Government who have run out of steam, have nothing left to offer but division and want to silence the very people who keep this country going—shame on them.