Health

Rebecca Pow Excerpts

Tuesday 14th May 2019 Commons Chamber

[Matt Hancock]

As I have said, I will come on to the details because there is undoubtedly work to do. Normally, we work on these issues in a fairly non-partisan way across the aisle. If we take tackling the problems of children of alcoholics, the hon. Member for Leicester South and I have worked together on that, and I pay tribute to the work he has done. In fact, he normally comes to this Chamber—as he did yesterday, for instance—in a spirit of discussion and objectivity to try to improve the health of our constituents. He is normally an extremely reasonable man. He is a very nice man. I know that he agrees far more with me than he does with his own party leader. Generally, he takes the approach of being constructive. I accept, and we accept, that improvements need to be made and we on this side of the House are determined to make those improvements, but we have to start from a basis of objective fact.

[Rebecca Pow (Taunton Deane) (Con)]

The Secretary of State is making a really powerful case. On mortality, I would say that, far from the age going down in Somerset, it is going up. This is a good thing, but the conditions from which people are suffering are getting more complex. This is something we have to address. Indeed, I know the Government are seriously looking at it with many of the models they are bringing in.

[Clive Efford (Eltham) (Lab)]

rose—

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[Rebecca Pow (Taunton Deane) (Con)]

I am very pleased to follow the hon. Member for Westmorland and Lonsdale (Tim Farron), and to talk about the Government’s commitment to public health. This Government are providing an additional £4.5 billion for primary and community health services as part of the long-term plan for the NHS. In ensuring that this plan operates properly, a renewed focus has been put on prevention. When the Prime Minister announced the £33.9 billion funding boost for the NHS, she said that the accompanying 10-year plan must have that focus on prevention. As hon. Friends have said, none of this is possible without a strong economy and without a Government who understand that tackling the debt and the deficit is really important, because we cannot have the services we want unless we do that.

One of the key parts of the plan is the importance of new screening methods. Earlier testing for bowel cancer is one of the issues that will be dealt with. I want to say a big thank you for the grant of £79 million that we got to build new theatres at Musgrove Park Hospital, which is Somerset’s main hospital but also a really big hospital providing services across the south-west. With part of that grant, it is building a whole new endoscopy service and suite. This really will help the population not just of Somerset but of the whole south-west with early diagnosis, which is the way we have to go. We also have a new MRI scanner, thanks to the community, which contributed towards it. That will help a great many people by picking up diseases early.

Somerset has a wonderful record on diabetes. Diabetes is a big issue, and amputations are very costly. One amputation costs £20,000, and a person with diabetes who has a limb amputated—sadly, that is what can happen—unfortunately then has a life expectancy of only five years. Somerset has implemented a diabetes foot pathway, which cut amputations from 122 to 66 in 2017. Not only are people living better and more healthily, but that pathway is saving the NHS a huge amount of money. That is the kind of model we need to put in place.

The public health grant remains ring-fenced, which I am very pleased about, and protected exclusively for improving health, but local government spending on health is not just about the grant. It is about local authorities being able to prioritise what they think is important, and indeed they are, with a range of innovative models in Somerset.

One third of Somerset residents will be 65 or over in 10 years’ time, compared with 21% nationally, and that has to be dealt with as a matter of urgency. Somerset County Council is responsible for all adult social care, children’s services and special needs, which take up 70% of its budget. While I welcome the Government giving another £240 million to adult social care and enabling local authorities to add adult social care to their precept, there are still pressing issues in Somerset that must be dealt with relating to the elderly population. Despite a great number of pressures, the council has done really well in sorting out its finances thanks to some tough decisions, but we have to make the resources go further. The council will be the subject of a “Panorama” documentary soon.

We must have better models. One model I want to mention is micro-providers. A list of self-employed, accredited providers can be accessed for all kinds of care and health needs across Somerset, so that people can stay at home, and providers go in to help them. We are using it at home for my family, and it really is a good model. I hope the Under-Secretary of State for Health and Social Care, the hon. Member for South Ribble (Seema Kennedy), will visit us to have a look at it.

We need to do more. While 92% of our care providers in Somerset are good or outstanding, which is above the national average of 83%, the current spending review needs to acknowledge that the pressures from not only the growing costs of care but being a rural county are different from those in other places. Somerset gets £730 of Government funding per head of population, which is 11% less than the national average. Our school transport gets less money than urban areas, and our public health funding from Government is only £36 a head, compared with £56 nationally. Will the Minister—

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

Order.

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[Rebecca Pow]

The diabetes foot pathway relied on opening eight podiatry clinics across Somerset. Does my hon. Friend agree that it is the podiatrists who are helping to solve the diabetes problem?

[Derek Thomas]

I completely agree with my hon. Friend, and I attended a conference 18 months ago at which the podiatrists and Plymouth University mentioned the risk of this happening. We are now seeing that prophecy being fulfilled. I appreciate what my hon. Friend says about what has been done to improve the pathway and reduce lower limb amputations. We must not see that good work reversed.

When it comes to caring for our feet, we are heading for a perfect storm. Fewer people are going into training because of financial barriers, and in 10 years we will see an enormous amount of podiatrists retiring from the profession. That adds up to a real challenge that we need to address quickly. I ask the Minister to look at what has happened since the nursing bursary was removed for mature students and whether we can address that.

The impact on patients is severe. Type 2 diabetes is the fastest growing health threat facing our nation, and 3 million people are living with it. That figure is set to reach 4 million by 2030. Diabetic foot care costs the NHS in England between £1.1 billion and £1.3 billion a year—£5.7 million per clinical commissioning group. It accounts for £1 in every £100 spent, more than the combined cost of three of the four most common cancers. Some 80% of the 135 lower extremity amputations each week in England are preventable through good foot care, and the Government have made a commitment in legislation and policy to provide safe care. That is just one example of how, if we do not get this right, we will fail to avoid the impact on patients of more lower limb amputations and lower life expectancy. The facts show that after a lower limb amputation, life expectancy is reduced to about five years.

There is also an impact on the NHS. I have mentioned the sheer cost of caring for lower limb problems, and it will have an impact on multidisciplinary teams if we do not keep people with the skills coming through. It will also have an impact on budgets. As well as the impact on social care and on the budgets for those delivering support in people’s homes, making changes around a home because someone has had a lower limb amputation is a costly affair that is easily avoided if we get it right and get enough podiatrists on the ground.

There is an urgent need for action. I ask the Government to look at why mature students are uniquely impacted when going to study these important professions. If a mature student is on any sort of benefit—housing benefit or other financial support—the minute they take out a student loan to study to be a podiatrist, they lose all that support. Perhaps the Department of Health and Social Care and the Department for Work and Pensions need to look at that, because that is a significant barrier to people coming into a skill we so badly need.

I ask the Minister to look at solutions to reverse the reduction of mature students going into important parts of the NHS such as podiatry so that we can save money for the future, to be used where needed, and provide a real opportunity to improve people’s lives.

Tessa Jowell Brain Cancer Mission

Rebecca Pow Excerpts

Monday 13th May 2019 Commons Chamber

[Matt Hancock]

It shows the power of bringing people together that we can agree with the Scottish National party’s Front Bencher on the importance of this agenda. I am delighted that the research spans the whole UK. The National Institute for Health Care Reform is reserved, and health research takes place throughout the country, and indeed internationally—throughout Europe and the world as a whole. Much of the best research is global, and that must continue. I shall be happy to work with colleagues in the SNP Government to further this mission and this end. Innovations of this kind are of course available to the NHS in Scotland, but the decision on whether to roll them out there will be a matter for Scottish Ministers, as that element is devolved.

As for the question of Brexit, I have absolutely no doubt that whatever form Brexit takes, we will do everything we can to ensure the continued and unhindered flow of medicines. We did an enormous amount of work to ensure that was the case ahead of 29 March. I have seen the comments the hon. Gentleman mentions from the company that supplies this drug. I see absolutely no reason to think that Brexit should have any impact at all on the ability to use this cutting-edge drug to save people’s lives.

[Rebecca Pow (Taunton Deane) (Con)]

First, may I thank everyone in Taunton Deane who was involved in raising money for the new MRI scanner? It was a huge local team effort. May I also welcome today’s announcement and the use of this dye, which will potentially save 2,000 patient lives and which is to be rolled out into all those neurological centres? That is wonderful news and demonstrates that where there is a will in this place there usually is a way.

I also want to highlight the following. Does the Secretary of State agree that when we are talking about this issue, we should also remember cancers that spread from other parts of the body to the brain—it is called metastasis? This is a very complex area and it needs more input in just the way that we have looked at this issue. Does the Secretary of State agree that we ought to look at that in more detail? Unfortunately, I speak about this from experience, with a close family member being involved.

[Matt Hancock]

I know about my hon. Friend’s, sadly, personal experience with this horrible disease and pay tribute to her for speaking up because it is not easy. She is right to raise another frontier that we must cross, and I am fully open to research bids in this area to work not just on brain cancer but on brain cancer that is a secondary cancer, because that is a very important area to get right, too.

Access to Medical Cannabis

Rebecca Pow Excerpts

Monday 8th April 2019 Commons Chamber

[Matt Hancock]

I will look at that idea and discuss it with the NHS. The training programme that we are putting in place is intended to raise awareness of the evidence and the change in rules among the profession—among doctors and the specialist prescribing doctors on the register. Ultimately, it is only with clinical sign-off that we allow any drug to be prescribed. That is where the training needs to be in the first instance, but I will look at the hon. Lady’s suggestion of doing it more broadly.

[Rebecca Pow (Taunton Deane) (Con)]

Anyone who goes through the heart-rending experience of seeing a very sick family member suffer will know that they would do anything to help that person, often reaching the point of desperation. People need to be confident that they can get hold of cannabis-based medicines if it is appropriate and that those medicines are safe. In this instance, there is a lot riding on the shoulders of our doctors. Will my right hon. Friend assure us that doctors are being given the right guidance to do what is right for patients, but also that they will not be blamed if something goes wrong?

[Matt Hancock]

Yes, I think that is exactly the right approach and it is what we are working towards.

Exiting the European Union (Food and Agriculture)

Rebecca Pow Excerpts

Tuesday 19th March 2019 Commons Chamber

[Steve Brine]

I would have been disappointed if my hon. Friend had not raised the subject of antimicrobial resistance. He is ingenious in managing to get it into every debate. He knows of my commitment in that regard, not just domestically but internationally. This country is rightly respected and looked to for its work in the field, and I thank him for putting that on the record.

[Rebecca Pow (Taunton Deane) (Con)]

We have received assurances from the Secretary of State for Environment, Food and Rural Affairs that in no way will any of our food standards be lowered as we leave the EU. That is very important to all our constituents, not least the people of Taunton Deane. Will the Minister assure me that we will stick to that, and, indeed, that there might be opportunities to raise our standards so that we are effectively a leader in many areas of the food, farming and animal feed sector?

[Steve Brine]

My hon. Friend makes a good point, and it is an interesting one to bring up at this moment. We have been very clear across Government from the Prime Minister down, including the Environment, Food and Rural Affairs Secretary, that we will not lower our standards in pursuit of trade deals as a result of leaving the EU, and that we will use all the tools at our disposal to make sure that standards are protected and we are not therefore left at a competitive advantage. My hon. Friend mentioned the Environment Secretary, who made that point very clearly at the Oxford farming conference, I think earlier this month. That is very much where this House is, and that is very much where I am as Minister responsible for food safety. I hope that is clear.

The law governing GM food and feed provides a harmonised regulatory framework. The authorisation process involves a safety evaluation based on rigorous scrutiny of scientific data by the European Food Safety Authority in line with international guidelines. GM events for use as food and/or feed are authorised by means of individual pieces of legislation. Authorisations are granted for a period of 10 years, which may be renewed if, following assessment of the required renewal data, the previous risk assessment remains valid. The rules also provide for the withdrawal of authorisations in appropriate circumstances.

There are also very clear requirements for the traceability of genetically modified organisms and the labelling of GM food and feed products, and importantly this enables products to be tracked through all stages of the supply chain. So the instrument ensures the continuation of these robust and effective GM food and feed safety labelling controls after we leave the EU.

As was the case with the other SIs, this instrument will make no change to policy beyond the technical amendments necessary, but it assigns powers and responsibilities currently incumbent on EU entities to appropriate UK entities. So I want to be clear that powers to make legislation, and risk management functions currently held by the European Commission to authorise GM food and feed and revoke or modify authorisations, will be assigned to Ministers in England, Wales and Scotland and the devolved authority in Northern Ireland. Those include discretionary powers to set down detailed rules that work for the UK in relation to the UK reference lavatory—laboratory, sorry, not lavatory; that would be strange.

Returning to industry, no changes to the way in which UK food or feed businesses are operated or regulated will arise from this instrument. There will be a continuation of the robust authorisation system I have outlined, the labelling requirements I have touched on, and the controls for GM food and feed that UK industry is familiar with and relies upon. The instrument enables the continued use of GM food and feed authorised in the UK. Again, the devolved Administrations provided their consent for it.

Thirdly, the Novel Food (Amendment) (EU Exit) Regulations 2019 are another instrument to be made under the powers of the European Union (Withdrawal) Act 2018. Novel foods are those that are relatively new or do not have a significant history of consumption in the EU. Those foods must be assessed for safety before they are introduced into the market to ensure that they do not present a risk to public health. This instrument will ensure that the regulation of and controls on novel foods continue to function effectively after exit day and that public health is protected. Anything permitted prior to exit day will be permitted after exit day. The purpose of the instrument—which again makes no policy changes—is to rectify deficiencies in the retained legislation. So foods new to the market are not assumed to be safe; that is where we have decided to place the burden. In the interests of public health the regulations require novel foods to have a pre-market safety assessment to identify whether they pose a risk and how that risk could be managed. The regulations will ensure that the existing levels of public health protection and food safety are maintained.

The EU framework regulation on novel foods is supported by four implementing measures, which provide the detailed rules, data requirements and administrative procedures governing all novel products. This instrument will ensure that provisions in the four main pieces of EU legislation continue to function effectively after we leave. They will correct the following retained EU law: regulation 2015/2283, which is the main framework for regulation on novel foods; regulation 2017/2469, which provides administrative and scientific requirements for the applications; regulation 2017/2468, which provides administrative and scientific requirements concerning traditional foods from third countries, which of course there would be; and regulation 2017/2470, which establishes a Union list of novel foods. Finally, regulation 2018/456 establishes procedural steps for the consultation process to determine the status of novel foods.

I know that food businesses watch these proceedings with interest, and there will be no change in how they are regulated. The instrument will, however, ensure that the robust system of controls that underpins UK businesses’ ability to trade both domestically and internationally continues. Again, we have engaged positively with the devolved Administrations, and we have their consent for this instrument.

Finally, the Animal Feed (Amendment) (EU Exit) Regulations 2019, which concern feed law, are also made under powers in the European Union (Withdrawal) Act 2018. We are making necessary amendments to the overarching food and feed regulations under the powers in the Act, so that we continue to protect the public. The primary purpose of this instrument is to ensure that feed legislation continues to function effectively. The retained EU legislation on animal feed encompasses requirements relating to feed additives, feed hygiene, sampling—when local authorities do sampling, for instance—marketing, and the use of feed, including labelling.

This instrument will fix the inoperabilities in the retained EU legislation and provide a continuation of the legal requirements that already exist in EU law. These proposed amendments are equally crucial to maintain a functioning statute book and to maintain public safety and confidence. The instrument introduces a number of changes, but the purpose of them is to ensure that the animal feed regulations remain operable after EU exit.

Risk assessment responsibilities, currently incumbent on EFSA, will be assigned to the Food Standards Agency and, again, Food Standards Scotland north of the border, and again, we have had consent from the devolved Administrations.

These four statutory instruments are all necessary to ensure that our legislation relating to food and animal feed safety and hygiene continues to work effectively after EU exit day. No policy changes are being made. I hope the House will support the proposed amendments in these four instruments to ensure that continuation, and I commend them to the House.

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[Rebecca Pow (Taunton Deane) (Con)]

It is absolutely crucial that the Government take seriously the protection of public health in respect of food. We pride ourselves on our high standards of food production. As I mentioned earlier to the Minister, my right hon. Friend the Secretary of State for Environment, Food and Rural Affairs made a commitment that we would in no way do anything to undermine or lower our standards as we exit the EU. I think a great many of us in the Chamber will be holding his feet to the fire on that commitment. Indeed, not only would we like to keep the standards that we have, but we may want to strengthen them. As my hon. Friend the Member for Truro and Falmouth (Sarah Newton) said, we may want to address packaging in a different way, for example, and we have an opportunity to do so.

I support the approval of these statutory regulations, remembering that they relate not just to the food that we eat, but to imported feed—the soya, the grain and the other myriad crops—for the animals that turn into our meat. The regulations must be in place on day one after we leave the EU, because it is important that businesses can just carry on working. I have met several people from the agricultural supply trade, and they have stressed that point to me, because they want to carry on with business as usual. I was therefore pleased to hear from the Minister that businesses are backing these regulations.

The draft Novel Food (Amendment) (EU Exit) Regulations 2019 deals with interesting foods such as chia seeds, which I have on my porridge every morning. They are supposed to be a superfood, so I thought that they may do me some good. They are new to the market and, like all novel foods, they had to undergo a pre-market safety check. I am pleased that the regulations mean that we will adopt the whole system that applies to novel foods, which is important for public health and safeguarding. New products must undergo an assessment of the level of risk and then an assessment of how to manage that risk and, quite rightly, we are adopting the tried and tested methods of the EU. They seem to be working so far because nothing untoward has happened to me as a result of eating chia seeds, and I hope that nothing will. It is important to continue to follow the process and to ensure that we keep the labelling and packaging right so that people know about novel foods.

I shall now turn quickly to the draft Genetically Modified Food and Feed (Amendment etc.) (EU Exit) Regulations 2019. It is essential that the system for GM food and animal feed is transparent and well regulated and that it involves a trusted safety evaluation based on sound science. We must adhere to a strict practice, and the EU has an established method, so I am pleased that we are adopting it. It is important to ensure that any process also applies to imports, because we do not want our industry to be undermined by any other country with lower GM standards, something that has been highlighted to me by several people when it comes to soya, for example. We must also ensure that the tracking and labelling systems are in place for GM products.

While we are adopting EU measures lock, stock and barrel, should the EU make any changes to its regulations, we should examine them and consider whether we want to adopt them and whether we may want to add some other standards. If we do that, we should use a bona fide method that protects our consumers while enabling the worldwide trade in which we want to engage.

I assume that the draft regulations will dovetail perfectly with the ambitions in the Agriculture Bill, which sets out plans for a completely new and exciting rethink of land-use policy and for delivering public goods for public benefit. While food is not specifically listed as public good, it is part and parcel of the Bill, and ensuring that we have high standards will be part of all that, so I would like some assurances from the Minister. One thing is for sure: we cannot mess around with food safety. Consumer safety is of utmost importance, and it is beholden on us to put measures in place to ensure that it is properly addressed as we exit the EU. I welcome the approval of these statutory instruments.

Oral Answers to Questions

Rebecca Pow Excerpts

Tuesday 15th January 2019 Commons Chamber

[Colin Clark (Gordon) (Con)]

15. What steps he is taking to improve and upgrade NHS facilities.

[Rebecca Pow (Taunton Deane) (Con)]

22. What steps he is taking to improve and upgrade NHS facilities.

[The Secretary of State for Health and Social Care (Matt Hancock)]

In September, we announced £145 million to upgrade NHS facilities for winter and, last month, £1 billion as part of the NHS long-term plan. Future capital spending decisions will be for the spending review.

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[Matt Hancock]

Yes, I love going to Aberdeen and look forward to another reason for going to the north-east. Of course, Aberdeen University and the UK have been at the cutting edge of this innovation for years and must be for years to come.

[Rebecca Pow]

I first thank the Department for supporting me in my case for upgrading the theatres at Musgrove Park Hospital.

Having skilled staff to work in these places is really important and the University Centre Somerset is one of just two places piloting the nursing associates programme. It is growing really well and it is a vital stepping stone between healthcare assistant and nurse. Will the Secretary of State join me in congratulating the college on how well the programme is going and meet me to discuss the option of a degree course?

[Matt Hancock]

Yes, absolutely. We support nursing associates and I am delighted to see the rapid expansion that is taking place. We want more universities and higher education institutes to come to the fore to provide that sort of education. I cannot wait to meet my hon. Friend.

NHS Long-term Plan

Rebecca Pow Excerpts

Monday 7th January 2019 Commons Chamber

[Rebecca Pow (Taunton Deane) (Con)]

I very much welcome this plan, its ambitions and the Government’s commitment to it. Does my right hon. Friend agree that one of the biggest obstacles to a fully functioning health service is the fact that information cannot be easily shared between many centres? There are myriad systems, which means that data cannot be accessed from one centre to another. When it comes to care, the professionals are brilliant and must be praised, but this situation is causing distress, and it slows diagnosis and wastes patients’ time. I speak from a great deal of personal experience, unfortunately, having spent too long in the NHS with family members. Can he give an assurance that that will be addressed by the plan?

[Matt Hancock]

Yes. I feel strongly about this. Chapter 5 of the plan is all about digitally enabled care. The interoperability of data between systems in different parts of the NHS is mission-critical. Over Christmas we published proposals for the interoperability of primary care systems, and we will roll that out in the hospital sector as well, so that people can access their own patient record and the clinicians who need to see it can access the whole record. Instead of having to phone each other up to find out what is going on with a patient they once had, they should be able to look at the record.

Mental Capacity (Amendment) Bill [Lords]

Rebecca Pow Excerpts

2nd reading: House of Commons & Money resolution: House of Commons & Programme motion: House of Commons & Ways and Means resolution: House of Commons
Tuesday 18th December 2018 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

First, I declare my interest as chair of the all-party group on social work. This very Bill was the subject of our most recent meeting, when we heard from those working in this sector. These are no doubt some of the most important issues we could be debating and legislating on, and judging by the attendance at the all-party group meeting, it could not be more important to the policy makers and professionals in the field. This legislation governs the rights of individuals and the people who can deprive them of one of their most basic fundamental rights—freedom.

Some of the people attending the all-party group felt the Bill had made some progress with the amendments in the House of Lords, but it is fair to say that the Bill is simply not yet good enough. I really think that the Government need to pause, think again about the implications of the plans that Ministers are putting before us today, listen to the countless charities, other organisations and professionals that work with the legislation every day and then come back with a Bill that is fit for purpose.

This cannot and must not be a basic political argument between the Government and the Opposition; it is a debate between law makers and the people, some of whom at a particular time in their life can be subject to some of the most restrictive legislation we have. It saddens me that this could be another Government measure to cut the costs of associated assessments under the current Act.

There is a wealth of briefing material, from organisations as diverse as the Law Society and the Royal College of Nursing, outlining concerns that need to be discussed and addressed through the legislation. There are serious issues with potential conflicts of interest, but I think the Minister knows that. Imagine a scenario in which a care home manager is making a decision on someone’s life but has a financial interest in making a judgment either way. The Royal College of Nursing shares my concerns on this. Care home managers may feel under pressure in their workplace, meaning that they may make decisions that are not always in the best interests of the person they are caring for. There should not be any vested interest—only an interest in the wellbeing and freedom of the person concerned. Issues have already been raised about private hospitals. A private hospital could authorise deprivation of liberty, knowing that it would benefit financially from that. I know that the vast majority of people are honest and work in the best interests of those they care for, but such judgments should be made by a genuinely independent person.

My hon. Friend the Member for Swansea West (Geraint Davies) mentioned the Royal College of Speech and Language Therapists. There is a real and genuine risk that people may be wrongly deemed to lack mental capacity because any communication needs they have are not properly recognised. Nothing short of full staff training on communication needs—for everyone in the system—would be satisfactory as a measure to ensure that people are being assessed correctly and that any additional needs are addressed.

[Rebecca Pow (Taunton Deane) (Con)]

The hon. Gentleman is making a very sound point. Given the importance of communication and of being able to assess people correctly, does he agree that it may be beneficial to add speech and language therapists to the list of approved mental capacity professionals, which would benefit some of the people being assessed?

[Alex Cunningham]

That is not something that has previously come to my attention, but I am sure the organisation would very much like to look at that possibility.

Following on from that, there must be a suitably qualified person carrying out the assessments and they must also be independent. A skilled approved mental capacity professional should be involved before a person is placed in an institution, not just when there is an objection or a trigger. There needs to be further clarity on the role of independent mental capacity advocates. Considering that the Bill in its current draft would allow responsible bodies to detain someone without renewal for up to three years, leaving people deprived of their liberty for inappropriate lengths of time, it is essential that there is genuine independence when it comes to such an assessment.

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[Geraint Davies (Swansea West) (Lab/Co-op)]

I speak as the chair of the all-party parliamentary group on speech and language difficulties, so my primary concern is that people will have their freedom taken away simply because they cannot be understood rather than due to a mental capacity problem. The Minister will know that this is a big problem, with something like 10% of children entering school having a speech or language difficulty. Some 60% of young people in the criminal justice system have a speech or language difficulty, and yet speech and language therapy reduces reoffending from 39% to 26%, so it is a cost-effective intervention at that stage and would be even more cost-effective beforehand. Some 81% of children with emotional and behavioural disorders have unidentified language difficulties. Left untreated, 33% of children with speech and language difficulties develop a mental illness, and half of them commit crimes.

In other words, it is important to identify and provide support for people in such situations because, as we have already heard, it can cost £13,000 a week to keep someone incarcerated, but that may be happening simply because they have not been properly understood and have not received the support they needed. There is therefore a financial and moral onus on us to identify and provide therapy to reduce and reverse the development of mental health problems linked to speech and language difficulties.

The situation at the moment—it will be the same under the Bill—is that assessors often will not and do not recognise speech and language difficulties or cannot differentiate between them, and they often do not know how to support the client and communicate their needs.

[Rebecca Pow]

I support all the hon. Gentleman’s comments. He is making a strong case. Does he believe that staff training on communication ought to be included in the Bill, and that speech therapists should be included in the list of approved mental capacity professionals?

[Geraint Davies]

I was going to make precisely that point. The Royal College of Speech and Language Therapists has said that the list of professionals should include such therapists and that all professionals carrying out assessments should have speech and language training so that they can identify the issues that they currently do not identify and provide clients with support. I ask the Minister to consider the Mental Capacity Act (Northern Ireland) 2016, which requires that support must be provided for communication.

When people are deprived of their liberty, that comes through their lack of capacity to consent, which is questionable if there has been no proper assessment of speech and language difficulties. The person may have a mental disorder, and the action that is taken must be necessary and proportionate. If they object, a review is carried out, but there is no requirement that a speech and language therapist should be involved in the review, which is another change that needs to be made.

The central point is that speech and language problems do not mean a problem with mental capacity, but they are commonly misread as such, which obviously costs the public sector a fortune and costs thousands of people their liberty. As has already been asked, I ask the Minister to look carefully at these issues over a longer timeframe, because we are in danger of rushing this through under the heat and smoke of Brexit, and everything else, and we risk denying the liberty of people whose liberty should not be denied and costing the public sector a fortune when that money would be better invested in preventive treatment such as early intervention for speech and language problems.

Prevention of Ill Health: Government Vision

Rebecca Pow Excerpts

Monday 5th November 2018 Commons Chamber

[Matt Hancock]

We are reviewing questions around that issue, because we want to ensure the best possible prevention and early diagnosis.

[Rebecca Pow (Taunton Deane) (Con)]

I welcome the focus on physical activity in the new prevention strategy. First, how will the Secretary of State work with the Department for Digital, Culture, Media and Sport on this? Secondly, would not travelling to work provide a great opportunity? Activities such as walking, cycling, tennis before work, Mr Speaker, and my eight minutes of pilates are all cheap or free. What does the Secretary of State have to say about that?

[Matt Hancock]

Well, I wish I had time for eight minutes of pilates with my hon. Friend. I cannot think of a better way to start the day. I am delighted that the Secretary of State for Digital, Culture, Media and Sport was here for the statement. We have been working with his Department on the strategy because it is so important to work across Government.

Clinical Waste Incineration

Rebecca Pow Excerpts

Tuesday 16th October 2018 Commons Chamber

[Stephen Barclay]

The hon. Gentleman seems to be spending a lot of time on social media and not looking at the data on what is being done. There was a time when Opposition Members were used to the complexity of legal agreements and contracts and would have understood that mobilising 17 NHS contracts and maintaining NHS operations on those sites requires a significant amount of work. It takes time for Mitie to mobilise that contract—[Interruption.] If he gives me a moment, I will address directly the different concerns that he raised.

The hon. Gentleman’s first concern was that a statement given in October, with up-to-date information based on the work done leading up to it, was in some way incorrect because it did not pick up on early discussions within NHSI, which was only notified on 31 July. Obviously the concerns raised by HES about a lack of incinerators needed to be looked into. Having been looked into, those concerns were found not to have merit. The evidence for that is the fact that the new supplier, Mitie, has been able to secure 1,000 tonnes of incinerator capacity. If the hon. Gentleman’s central charge is correct, he will need to explain how Mitie has been able to find available incineration capacity when HES was unable to do so.

The hon. Gentleman asked when I was notified. I was not notified of the internal discussions among officials in August; I was not dealing with the issue at that point. The issue is what the House was informed of when the statement was made.

On the allegations on social media, I have not checked every single tweet that the hon. Gentleman has looked at, but the fact is that of the 17 trusts, three have had the stock of waste on their sites cleared and 12 are due to have theirs cleared by the end of the week, with two remaining, as Mitie mobilises from around 80% of service delivery now to 100% in the coming weeks.

The right hon. Member for Normanton, Pontefract and Castleford has made some legitimate points about TUPE and about Mitie scaling up, which I am sure she will come on to. Those points were not addressed, surprisingly, in the shadow Secretary of State’s comments, but I am happy to pick them up in due course. One of the advantages of Mitie is that it should deliver greater resilience, because it is not looking to deliver all the elements of the contract in the way that HES is. It is bringing in other firms, such as logistics suppliers and disposal firms, so there will be greater resilience in the contract, but we can address any specific concerns that the right hon. Lady has, given her constituency interest.

[Rebecca Pow (Taunton Deane) (Con)]

I thank the Minister for his clear words. I remember just how emotive the whole issue of incineration can be, because I was a news reporter at the time of the foot and mouth and BSE sagas, and it is something that worries the public. Can I have an assurance from the Minister that there is an industry-wide agreement that there is enough capacity everywhere to deal with incineration?

[Stephen Barclay]

My hon. Friend is right to identify the concern there has been following comments on social media and certain media reports about incineration and the nature of this clinical waste. As I said in my statement, I am happy to confirm that there is sufficient capacity, as Mitie has demonstrated. It is worth reminding the House that just 1.1% of the waste under discussion is anatomical, and many of the media reports do not reflect that.

Dangerous Waste and Body Parts Disposal: NHS

Rebecca Pow Excerpts

Tuesday 9th October 2018 Commons Chamber

[Stephen Barclay]

The hon. Lady is absolutely right that HES has sites in Scotland; I think there are four. The Scottish Environment Protection Agency has been conducting regular site inspections and we are looking closely at the situation there—not least regarding the movement of waste from one site to another. However, she is correct that we are not aware of any specific issues at those sites.

The primary purpose of enforcement notices has been to encourage the company back into compliance. That has been the focus of the Environment Agency. The reason for the partial suspension in Normanton has been the unwillingness of the company to respond. Some notices are for what might be seen as relatively minor issues such as documentation, but obviously some relate to the overstorage on these sites.

[Rebecca Pow (Taunton Deane) (Con)]

I am pleased that new contracts have been signed and enforcement action has been taken—and quickly—but what is really important are the lessons learned, so will the Minister expand on that? While this is a sensitive matter—understandably, it evokes all kinds of concerns for the public—will the Minister assure us that there has been no risk to patients at any time or indeed to the wider public from this most concerning of issues?

[Stephen Barclay]

I am grateful to my hon. Friend for her question, and I am happy to give her constituents an assurance that there has been no risk to patients at any point during this time. As for lessons learned, clearly we will need to look at some of the lessons, particularly what triggers a breach of contract. A series of contracts were held by a wide number of trusts with the supplier, and it is important that we look at what the notification periods are, what the monitoring and enforcement processes are, and what powers there are under the terms of the contract to ensure that the company is acting as it should.