Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 8th June 2021 Commons Chamber

[Ms Dorries]

The short answer to that question is no, and that is why we have committed an additional £500 million to address some of the issues that the hon. Gentleman highlights. However, I must reiterate that the majority of our targets, where they have been set, are being met. Sadly, in eating disorders—I hold my hands up—we are not meeting the targets that we want to, but as he may be aware, we are trialling four-week waiting targets for children and young people. The results of that review and pilot will be available soon.

We continue to look at ways in which we can increase access to services for children and young people. Children and young people have told me themselves, via organisations such as Barnardo’s, that they want their mental health services delivered in a different way. They do not want to go and sit in a village hall or a hospital, or wherever they may receive their services from community practitioners; they want some of their services delivered via their phones, laptops or computers. Obviously, one-to-one services have to be available where they are needed, but children and young people are demanding a change, and we are going through that change now.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

My hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) raises a very important point and, frankly, I am shocked that the Minister seems so relaxed about it. Across the country, there are numerous children who have waited more than 400 days for help with autism; 280 days for post-traumatic stress disorder; 217 days for suicidal ideation; 195 days for treatment after an overdose—I could go on and on. Children should not have to wait so long for treatment. That will have a scarring impact on their development. These waiting times simply are not acceptable, so will the Minister apologise to these children, and can she explain where it went so wrong?

[Ms Dorries]

I do not believe that meeting almost all our targets for NHS waiting times for mental health services, with £2.3 billion a year of investment into our NHS and no NHS mental health service closing during the entire pandemic, has been a failure. Of course I am sorry for those children and young people who cannot get access to services as quickly as they want; that is exactly why we committed an additional £500 million and established a mental health recovery plan: so that we can put community services in place to reach those who have been impacted most by the pandemic over the past 15 months. We have a long-term plan in place, with the investment that the NHS tells us that that long-term plan needs to provide the very services that we want to provide. The mental health of children and young people is this Government’s priority. We will continue to invest, and are proving to continue to invest, to make sure that those children and young people access the services they need.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 13th April 2021 Commons Chamber

[Ms Dorries]

I thank the hon. Lady for her important question. The mental health and wellbeing recovery action plan published on 27 March this year aims to respond to the impact of the pandemic on people’s mental health, specifically targeting groups that have been most impacted. She mentioned the Good Grief Trust, and I mentioned the £10.2 million of funding that we have allocated recently. That is on top of the £2.3 billion a year for general mental health, which includes bereavement counselling, and the £500 million additional spending that we received in the spending review. Some of that money did go to the Good Grief Trust, which has done a fantastic job. It has been signposting services by putting cards in doctors’ surgeries and in A&E departments in hospitals so that people have immediate access to a line, but there are 700 other charities across the UK that are providing bereavement and grief counselling services to many members of the public. We recognise that the demand is high, but the services are there and available.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

With your permission, Mr Speaker, I will pay a tribute to my father, Mohammad Aslam Khan, who passed away a few days ago. Not only was he a keen cricketer and an amazing dancer, he was also a champion of equality. He was incredibly strong and brave until his very last breath and he shall be missed beyond measure. I extend a huge thank you to all the team at St George’s, especially the marvellous team on Dalby ward, also to Victor and the incredible staff and carers at Ronald Gibson House and to a wonderful nurse called Anne Wheeler. My brother and I saw at first hand that not all angels have wings.

Covid-19 has stripped the humanity out of grieving, with millions being unable to attend funerals, say final goodbyes, or be with loved ones following a death. Last year, the Government provided £10.2 million to mental health organisations to ensure that services could continue during the pandemic. Many people have been relying on the support of dedicated bereavement organisations to help them cope, yet the extra financial support ended on 1 April. Will the Minister please consider reviewing this vital funding immediately to ensure that no one has to go through bereavement alone?

[Ms Dorries]

I pay tribute to my hon. Friend and her brave words about her much missed father. Politics divides us, but grief, for many reasons, unites us across this House. I have personally declared to my hon. Friend that I am here should she need me. I pay tribute to her for her bravery, being here today so soon after the loss of her wonderful father. I hear her request; it is constantly under review. Bereavement services are incredibly important to me personally and to many of us. She mentioned the £10.2 million. There are 700 bereavement charities, including the Good Grief Trust. We monitor carefully how people access bereavement services. We know that there is an increased need at the moment and that is being watched very carefully. My hon. Friend is incredibly brave.

Maternal Mental Health

Rosena Allin-Khan Excerpts

Wednesday 10th March 2021 Westminster Hall

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Edward, and it is an honour to respond on behalf of the Opposition in this vital and incredibly moving debate. I thank the hon. Member for Richmond Park (Sarah Olney) for securing the debate. All contributions have been incredibly valuable and have highlighted the urgency of focusing attention on maternal health. Debates such as these can go some way towards breaking down the stigma that still persists around mental health and the often harsh reality of pregnancy, birth and motherhood. It is simply heartbreaking that suicide is the leading cause of maternal death. More people are starting to speak up publicly about their experiences, but we need action from the Government.

The coronavirus crisis has had a disastrous impact on many women. I was honoured to listen to colleagues sharing their heartbreaking experiences of baby loss in a recent debate. My heart breaks for all the women who have had to go through that alone at any time, especially during the pandemic. It is simply inhumane. Will the Minister outline what mental health support will be offered to women who have experienced baby loss without their partner by their side? Such tragedies have a long-term impact on partners and families, too. Will any support be extended to families? We heard described today, very eloquently, the importance of also considering fathers and other partners in such circumstances.

Within maternity services, there are huge inequalities. Black women are four times more likely than white women to die in pregnancy or childbirth. Pakistani women are more likely to have a premature baby or a neonatal death in the UK compared with their country of origin. Women from all ethnic minority groups in the UK receive fewer home visits from midwives and are more likely to give birth by emergency caesarean sections. What are the Government doing to address those discrepancies and to ensure that culturally appropriate mental health support is provided? Such racial inequalities are deep rooted and are further entrenched by covid-19. People from ethnic minority backgrounds are more likely to be adversely impacted financially by the pandemic, and the risk of death is much greater.

The Government’s only response so far to those shocking statistics has been to commission further research, but we need action now. The evidence is already clear that there are persistent inequalities in maternity outcomes and experiences, and that discrimination bias and a lack of cultural understanding are driving that. What action are the Government taking to eradicate these gross examples of health inequality? The five-year forward view for mental health made a recommendation that by 2020-21 in England 30,000 more women each year should be able to access evidence-based specialist mental health care during the perinatal period. During Monday’s statement on women’s health, I asked the Minister if she could tell us whether that target had been met. We did not get an answer, so will she provide one today?

Furthermore, the NHS long-term plan outlined that an additional 24,000 women per year with moderate to severe perinatal mental health difficulties and a personality disorder diagnosis would benefit from evidence-based care by 2023-24. Will the Minister please outline how many women are now benefiting from that? We also know that Health Education England was provided with £1.2 million of funding to increase skills and awareness around perinatal mental health. Will the Minister outline the progress on that and tell us where training initiatives might have been hampered by the pandemic?

The pandemic has had a profound effect on people’s mental health. We know how difficult and stressful pregnancy and birth can be at the best of times. Even outside of covid-19 it is vital that perinatal mental health services should promote prevention, early detection and diagnosis of mental health problems. Many women have been struggling to access the services they need during pregnancy, leaving them having to go through A&E. That is hugely distressing and can cause a great deal of anxiety for expectant mothers and their partners. It is therefore vital that those most at risk get the support they need now. Will the Minister outline what delays there have been during the pandemic in accessing perinatal services?

Working in a hospital, I have seen the fear that so many people present with: fear of contracting the virus, fear of taking the virus home and fear of wasting NHS time. Preventive measures around mental illness are crucial, especially now, for those most at risk. With more than half of new mothers having reported feeling down, lonely or irritable, and 71% reporting feeling worried since the beginning of the first lockdown, what steps is the Minister taking to ensure that new mothers know where to go to seek help?

A University College London report found that, during the pandemic, there was a redeployment of up to 80% of health visitors in some areas. That prevents the much-needed visits that we heard about earlier. Face-to-face visits are crucial in recognising issues early and in providing assistance. Will the Minister tell me what delays families have faced at this time and whether any additional resources will be offered to those who missed out on face-to-face visits?

As a mother of two under two at one point, I know how desperately stressful it can feel to have one baby already and have a new one arrive. I know what it is like to feel as though you are failing at motherhood and at being a working mother. I know just how challenging it can be, but I cannot imagine for a moment what it would have felt like to do that through the pandemic. We rely so much on being in playgroups, having other mothers and fathers telling us we are doing okay, and phoning the breastfeeding helpline at 2 am worried that you cannot make enough milk for your baby and having someone say, “Don’t worry. We can get a health visitor to come and see you tomorrow.” These are normal things, but for so many mothers they have been lacking throughout the pandemic. I fear for the effect that that will have on them, their families and their children in the long term.

My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) asked last year about the additional counselling and support being provided for those who gave birth during lockdown. I noted that there was no clear answer on the proactive work that the Government have done to provide support to new parents. I ask the Minister whether that was because no additional resources have been provided. Does she recognise that maternal mental health has been overlooked in this crisis?

Pregnancy and childbirth can be such a beautiful time in people’s lives, but I know what it can feel like when it goes wrong. I know the fear of stepping into a hospital afterwards—the memories come flooding back. Your heart rate goes up, and you cannot even imagine what it would be like to be pregnant and to go through childbirth again. These things can be overcome, but not without the specialist help that people really rely on. I cannot imagine what it must be like for women going through this during covid, and yet it is another barrier in the way of getting the help that they and their families desperately need.

Women’s Health Strategy

Rosena Allin-Khan Excerpts

Monday 8th March 2021 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I thank the Minister for the advance copy of the statement. I wish every woman in the House and throughout the country a very happy International Women’s Day.

It is welcome that the Government want to understand the plight of women throughout the country, but although the Minister said that this strategy is the first of its kind, in reality it is not. We heard much that was in this announcement when the Government launched the women’s mental health taskforce in 2017. If the Government took this matter seriously, it would be a first. The Minister responsible for mental health at the time, the hon. Member for Thurrock (Jackie Doyle-Price), said:

“This report is a call to action for all providers, commissioners and practitioners across the health care system to drive forward the ethos of trauma- and gender-informed mental health care.”

That echoes what the Minister just said, so why are the Government asking the exact same questions four years later?

A multitude of health concerns are unique to women and are often overlooked. In hospital, I hold the hands of women in their darkest times: young women and girls presenting with eating disorders; trans women admitted after suicide attempts and substance abuse because they had been made to feel as though they do not belong; and women of colour presenting far too late with conditions that could have been easily treatable if they had found healthcare more accessible. I meet many women victims of domestic violence. They use healthcare services more than non-abused women, so I hope to see the Government’s upcoming violence against women and girls strategy address their needs.

The coronavirus crisis has had a disastrous impact on many women, and I have been honoured to listen to colleagues share their heartbreaking experiences of baby loss. My heart breaks for all those women who have had to go through that alone during the pandemic. What support will be offered to women who experience baby loss without their partners by their side? Within maternity services there are huge inequalities. The Minister is right to highlight the fact that black women are four times more likely to die in pregnancy or childbirth, and I welcome the launch of the forum, but the Government have known about these inequalities for years, so why has there not been action sooner? The Government are running a separate sexual and reproductive health strategy; would it not have made more sense to bring it, as part of that working, into this? A part of this which is widely stigmatised is the menopause. How will the Government be seeking to engage women who have to go through difficulties throughout the menopause?

The “Five Year Forward View for Mental Health” recommended that by 2020-21, in England, 30,000 more women each year would be able

“to access evidence-based specialist mental health care during the perinatal period”

and said that that was important. Can the Minister tell us whether that target has been met? Today, it is huge news that a woman of colour has spoken about her mental health struggles during pregnancy. Many women face difficulties but stay silent, afraid to seek help. With stigma attached to mental illness, the Government must ensure that evidence is collected from all of our ethnically diverse communities.

Women are still being misdiagnosed in 2021. With male bodies being seen as the default body, there is a huge historical data gap in understanding women’s health needs. It is shocking that women are 50% more likely to be misdiagnosed following a heart attack simply because our symptoms differ from those of men. What research will the Government commission to bridge that divide?

Finally, pay is a gendered issue. Women are 82% of the social care workforce and 90% of the nurses. Can the Minister justify the real-terms pay cut to our frontline NHS staff? Will she end poverty wages in social care? We need healthcare to work for every woman across the UK—young and old, white and women of colour, cisgender and transgender. We cannot wait any longer. Women’s health and wellbeing should not be an annual PR exercise. We need action and we need action now.

[Ms Dorries]

I join the hon. Lady in wishing every woman across the world a happy International Women’s Day. She opened by talking about the mental health taskforce and saying it is not the first of its kind, but it absolutely is. It was a five-year project that the NHS used to bring together women and organisations from across the healthcare sector to develop a mental health plan—a five-year view—which it did and reported on. As she knows, partly as a result of that, we now have the long-term plan in mental health.

The hon. Lady also spoke passionately, as she always does, about the patients she meets as part of her work and the women who are suffering from eating disorders—sadly, that has been a tragic cost of covid. We know that two groups have been affected by the past 12 months in the mental health sphere: people, including women, with pre-existing mental illness; and, in particular, young women aged 15 to 26, in whom we have seen an explosion in the number of referrals—I believe the figure is 22% for young women seeking help with eating disorders. We have committed funding during the spending review, when £500 million was announced, and I announced £79 million on Friday. Part of that is going to deal with the problems that we have as a result of the pandemic, and with young women and girls—and in some cases young men—who are suffering from eating disorders.

The hon. Lady talked about the stillbirth and neonatal target of halving the number of stillbirths by 2025. We are way ahead of our target on that. The Office for National Statistics published new data last week, and I believe we are looking towards a 30% figure already. We are way ahead of target, and that is a result of the measures that have been put in place in the maternity safety arena, including the saving babies’ lives care bundle and the early notification scheme.

I reiterate that what we are announcing today is a call for evidence from women everywhere in the UK: from every organisation and every friend, every partner, every family of every woman.[Official Report, 12 March 2021, Vol. 690, c. 5MC.] The link has been published today. I published it on the Government website and it is on the Department of Health and Social Care website and on my Twitter feed. It is a link that women can easily access using their phones or their laptops, and it takes a few minutes to complete. We want to develop the first ever women’s health strategy within the Department of Health and Social Care that will deal with all the issues—there are too many for me to talk about now—and all the ways in which women have been affected. These will include research funding and cohorts of trials not using women, using all the information that we have from Paterson and Cumberlege and from women stating clearly that women are not listened to in the healthcare sector. To address that, we need to hear not just from the Paterson women and the mesh women who spoke to Cumberlege; we need to hear from all women everywhere, and that is why we have launched this call for evidence today, to develop this strategy before the end of the year.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Ms Dorries]

I wholeheartedly agree with my hon. Friend, and I would also like to pay tribute to Sir Simon and his co-chairs for their comprehensive work. The Secretary of State said in the House last year that

“the Wessely review is one of the finest pieces of work on the treatment of mental ill health that has been done anywhere in the world.”—[Official Report, 23 June 2020; Vol. 677, c. 1164.]

I know that the review was welcomed by hon. and right hon. Members across the House. We are taking forward the vast majority of Sir Simon’s 154 recommendations, either directly or by advancing the principles put forward by the review. The White Paper document contains the Government’s response to each of the recommendations.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

The overhaul of the Mental Health Act has been long awaited. It is people who have to be at the heart of the legislation, and that includes staff. The promises that the Secretary of State has made rely on a workforce: our fantastic frontline mental health staff, of which there are simply too few at present. I asked him last month to outline when we would get the workforce settlement and what reassurance he could give on filling the training places. We are still waiting for an answer. Would the Minister like to answer now?

[Ms Dorries]

Work is under way; Health Education England is looking at proposals, particularly for the training of mental health workers. I wish to highlight one area where we can see that happening rapidly: in the mental health support teams that are going into schools. People are coming out of universities with their degree and going through a year’s training so that we can get them into schools faster to work with children and young people. The hon. Lady is right; the mental health workforce is at the heart of these reforms. I assure her that we have seen an increase in the number of people applying to be mental health nurses—and nurses across the healthcare estate—and that will have a knock-on effect on the number of people we have working on the wards with people who have severe mental illness.

Long Covid

Rosena Allin-Khan Excerpts

Thursday 14th January 2021 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I would like to begin by thanking the hon. Members for Oxford West and Abingdon (Layla Moran) and for Central Suffolk and North Ipswich (Dr Poulter) and my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) for securing the debate, and I thank all Members for their very personal contributions.

For thousands, covid-19 is something neither succumbed to nor overcome in a matter of days. For many, it has lasting mental and physical impacts that affect the body many months after initial infection. It is nearly a year since the first case of coronavirus was recorded in the UK, and still very little is known about the debilitating post-covid syndrome. I pay tribute to the LongCovidSOS group and all the online support groups that work tirelessly to raise this issue and support one another.

At this stage, we cannot say with any real certainty what exactly long covid is. Nor we can accurately predict the true number of people suffering symptoms of long covid. The Office for National Statistics has published estimations suggesting that the proportion of people displaying symptoms for a period of over 12 weeks could be as many as one in 10. Let us be clear, this is not a syndrome being experienced by a small minority of people. There is also finite evidence on the best way to treat the condition, which has vastly varied symptoms. Without a clear understanding of exactly what the condition is, this makes it far more difficult for health professionals to manage and support those who are affected by it. With better data collection and further research, and by listening to those living with long covid, we can begin to effectively treat the condition. Will the Minister please outline what work the Government are doing to close this gap in knowledge?

What we do know for certain is that the symptoms of long covid can be severe, completely debilitating and utterly crippling, preventing people from living their normal lives. This impact can have a detrimental effect on people’s mental health, their wellbeing and, as we have heard today, their physical wellbeing. It leaves many unable to return to work months after their initial battle with the virus and causes a great deal of uncertainty in already anxious minds. It is crucial to understand that this stress and anxiety can cause relapses in the condition, as sufferers themselves have told me.

Many people with long covid do not know when or if they will return to work. Without action from the Government, the long-term social and economic consequences of this could be grave. Key workers have an increased risk of catching covid. NHS workers in particular are at least three times more likely to contract it than the general population, and this could wreak havoc on our frontline workforce. What steps are the Government taking not only to protect the NHS workforce further but to ensure that staffing levels are such that patients continue to be treated and the population continues to be vaccinated?

The availability of treatment and care for individuals experiencing long covid must be a matter of immediate concern to the Government, and I urge them to adopt a patient-led approach. Could the Minister please outline what progress has been made on setting up long covid clinics, and what plans the Government have to extend this programme in 2021? There simply cannot be a postcode lottery of service provision for long covid sufferers. No one person’s life is more valuable than another, and the Government must ensure that that is reflected in access to treatment.

Some long covid patients are being denied referral because they never had a positive covid test. For the many people who suffered with covid in the first wave back in March and April and were not eligible for testing at the time, that is proving incredibly frustrating. Will the Minister outline what measures the Government will take to ensure that people do not miss out on much needed treatment, particularly if they fall into the category of people who were unable to have a covid test in the first wave?

The Government have to step up and show leadership. There has to be clear messaging to the public to ensure that they are sufficiently informed about the condition and about where to seek help if they need it. That messaging needs to combat the misinformation about covid that is out there presenting it as a myth or similar to the flu. I would like to pay tribute to the former MP for Leigh, Jo Platt, who, along with LongCovidSOS and support groups on Facebook, is campaigning tirelessly on this issue. As Jo told me, there are no words to describe how covid deniers have made her feel. She said: “For people to seriously deny our experiences has been soul-destroying.” We have to get this right.

It is also essential that healthcare professionals at every level of the NHS are properly trained to treat long covid, distinguishing between the different conditions that fall under the term. This includes frontline mental health workers, as the mental health implications of long covid can be severe. Within an acute crisis, it is far too easy to push longer-term concerns to the periphery. Should the Government continue to do this with long covid, they do so at their peril.

Throughout this crisis, far too many people have felt that their voices have been silenced. For the sake of the health and wellbeing of all those living with long covid, please do not silence them. There is still so much that is unknown about this virus and how it affects us, but one thing that is certain is that long covid should be a matter of serious concern, and without concerted action by the Government we may be living with the consequences of this for many years to come. We are still learning so much more about the impact of covid-19 on our communities, our bodies and our wellbeing. There are thousands of people out there currently suffering with long covid. They are relying on us, and on the Government, to get it right for them.

Mental Health Act Reform

Rosena Allin-Khan Excerpts

Wednesday 13th January 2021 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I thank the Secretary of State for an advance copy of the statement. This overhaul of the Mental Health Act has been long-awaited, and we welcome the White Paper and the fact that the Government have accepted the majority of the recommendations from Sir Simon Wessely’s independent review of the Mental Health Act.

Without a doubt, people need to be at the heart of this legislation. Service users must be involved in framing the legislation going forward, and when we talk of numbers and statistics, we must remember that these are real people with real lives and real families. There is a web of individuals who are affected when things go wrong. Deprivation of liberty and the use of coercion can cause lasting trauma and distress. That is especially true for children and young people who find themselves in these most difficult of situations, whose voices often are not heard when decisions are being made. It is an important step that learning disabilities and autism will no longer be grounds for detention under the Act, and I am sure that we all welcome that. It is also very welcome that the recommendation on nominated persons has been included.

The best way to reduce coercion and detention is to have alternatives to admission. Will the Secretary of State please outline how that will be achieved? Community provision is vital for mental health services that are truly joined-up and, crucially, work well for patients, so will he also give reassurances on community care?

It is in our communities where we witness the harsh reality of health inequalities, which so desperately must be addressed. Social inequalities and adverse childhood experience are the drivers of mental ill health, and they cannot be ignored. Children from the poorest 20% of households are four times more likely than those from the wealthiest 20% to have serious mental health difficulties by the age of 11. That will not be solved simply by mental health legislative changes; there must be a commitment to addressing the vast chasm of health inequalities across the country.

At present, black people are over four times more likely to be detained. We need to advance the mental health equality framework, and there must be culturally appropriate services and freedom for local areas to look at their specific population in order to have the most suitable approaches.

Mental health staffing levels are crucial to ensuring that mental health services are fit for purpose. The proposals set out by the Secretary of State go well beyond what has been committed in the long-term plan. We need to see true understanding from the Government that mental health is not about promising fancy equipment; it is about people. The promises in the White Paper rely on the workforce—our fantastic frontline mental health staff, of whom there are simply too few at present. Will the Secretary of State please outline when we will get the workforce settlement? What reassurance can he give on filling training places?

It has already taken so long to get to this point—it was the former Prime Minister who started this process, back in 2016—so will the Secretary of State provide some clarity on the timeframe going forward? Given the complexities of the legislation and the need for it to be robust, what are the plans for a joint prelegislative Committee? It is vital that the blueprint that Sir Simon Wessely’s report sets out is implemented in full. I would like to take this opportunity to thank him and everyone involved for all the work they have done on this review.

We must act, and quickly. Covid has shown us how all the pressures on mental health are building. We need action now. We all know how rare these pieces of legislation are; this is a once-in-a-generation opportunity to get it right for some of the most vulnerable in our society. We simply must get this right for everyone who depends on these services.

[Matt Hancock]

I thank the shadow Minister for her thoughtful approach. I agree with the way that she described the challenge, and with her insistence that we must not just improve the legislation—and we will—but improve and continue to strengthen service provision, in particular community service provision, as an alternative to admission. That is how we turn legislation from dry words on a page into real action on the ground.

The shadow Minister is absolutely right, too, that service users must be at the heart of framing the legislation. If I may link that point to her question about the timeframe, the challenge of the timeframe is to ensure that we move fast enough to help people and get the new legislation on the statute book as quickly as reasonably possible, but at the same time continue with the consensus-based approach that we have taken.

I am very grateful, as I said, for the work of Sir Simon and the NHS team, and I am grateful that we have managed to develop this White Paper with broad consensus among those who provide mental health services and service users, and politically across the House. I think that is an important consensus to keep, and I want to try to keep it by ensuring that we take as open an approach as possible to the legislation. I am absolutely open to joint prelegislative scrutiny, and I am absolutely open to the publication of a draft Bill. Let us get the details right, and let us work together on this and keep it as consensual as possible.

I also agree with the hon. Member’s point about the need to tackle broader health inequalities, and covid has laid bare some of those. That is a core part of our levelling-up agenda, and it is an important consideration for both physical and mental health. I am glad to say that this landmark White Paper, which will lead to a once-in-a-generation Bill, is proceeding with the support of the Opposition. I am really pleased about that, because this is for everyone. It is to make sure that some of the most vulnerable people in our country get the support they need and deserve.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 12th January 2021 Commons Chamber

[Edward Argar]

The hon. Lady is absolutely right to highlight the pressure that the NHS and critical care are under in London and, indeed, more broadly. I pay tribute again to all those who are working in the NHS, including my shadow, who I suspect has been on the frontline in recent days—I pay tribute to her, too. The best way we can thank them is by following the advice to stay at home and to follow the rules. In respect of her specific point, yes, we are involving independent sector capacity, Nightingale capacity and increasing NHS capacity—all those, alongside other measures—to ensure our NHS continues to be able to treat those who need this care at this time.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Last night, I finished a shift in a busy east London hospital, sharing difficult news with hopeful families. The resilience of staff on the frontline can never be matched, but across the country morale is on a cliff edge. A decade of cuts to beds, services and staff, combined with pay freezes, has left NHS workers undermined and undervalued. Without our incredible staff, a hospital bed is just that —a bed. So does the Health Minister regret how the Government have made frontline workers feel and can he promise to change that?

[Edward Argar]

I reiterate, as I did earlier, my thanks to the hon. Lady and all her colleagues in the NHS for everything they are doing. I reassure her, as I do and as my right hon. Friend the Secretary of State does at every opportunity, just how valued and supported our NHS is. We have put in place just over 1,000 additional critical care bed capacity at this time—the right thing to do. In addition, in respect of supporting staff, we are investing about £15 million—just one example—for mental health hubs and mental health support for staff. I saw, from the hospital that she works in, or has worked in, in her constituency, a number of staff—it was on the BBC recently—setting out just how flat out they are. The best way we can thank them, alongside what we are doing—I make no apologies for reiterating it, Mr Speaker—is by all following the rules to stay at home to help to ease the pressure on those phenomenally hard-working and valued staff in our NHS hospitals.

Covid-19

Rosena Allin-Khan Excerpts

Monday 14th December 2020 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I would like to start with a tribute to Dame Barbara Windsor. She holds a special place in the affections of the nation from her earliest days with the Joan Littlewood Theatre Workshop to being landlady of the Vic. Barbara Windsor asked us to make a stand against dementia, and we will. Our thoughts are with Dame Barbara’s friends and family.

It is now nine months since the first British patient contracted covid-19—nine months that have tested our national character, our national health service and our national leaders; and nine months of terrible grief for tens of thousands of families who face a Christmas with an empty chair at the family dining table. Torn apart with anguish and united in pain, those families were robbed of their chance to say goodbye and robbed of the last hug or kiss, and they are still unable to sleep at night.

Rates of depression doubled during the first wave, but referrals to mental health services dropped. Couple that with nine months of economic turmoil exacerbated by the Brexit shambles, with millions facing the dole or losing their homes and businesses, and people need assurances that their wellbeing will be protected. There are still 3 million freelancers and small business owners excluded from Government support and facing utter ruin, which takes a terrible toll on their mental wellbeing. Some of the 3 million excluded have even, tragically, taken their own lives. It is not too late for Ministers to do the right thing and support the 3 million excluded.

What a year it has been. When the British people were called upon to stand together against a common enemy and to rise to greatness, they were not found wanting. I am thinking of the people who queued down the street to volunteer to deliver food and medicine; people who donated to food banks and looked in on neighbours; and people such as Captain Sir Thomas Moore, who raised not just money, but our spirits and our sense of ambition. I am thinking of those who spearheaded the #WhatAboutWeddings campaign, supporting people whose wedding day plans were derailed and people in the wedding industry whose businesses disappeared. I am thinking of people in the Beauty Backed campaign, supporting workers—mostly women—in the multi-million pound beauty sector whose salons were closed and who could not work to feed their families.

I am thinking of our refuse collectors, delivery drivers, shop workers, shelf stackers, cleaners and others who kept the country running. I am thinking of workers in the social care sector—low paid and so often stigmatised—working at the sharp end of the pandemic in our care homes. These unsung heroes deserve real recognition. Perhaps next time we discuss low pay and minimum wage, we will remember how much we owe all these workers who make Britain tick. I want to give a special mention to Britain’s postal workers, who have played a special role in supporting our communities—not only delivering the post come rain or shine, but looking in on the vulnerable, raising the cheer of isolated and lonely people and being a friendly face amid uncertainty and fear. Britain’s posties, we salute you.

Of course, we praise the 1.4 million of us who work for our national health service. So many NHS workers risked their lives to fight the pandemic, and so many have tragically died. Many more are left with the trauma of dealing with mass casualties. The latest absence figures from the NHS show that just under half a million days were lost to mental ill health in just one month alone. With infections continuing to rise throughout the country and the Christmas easing of restrictions imminent, how will the Government ensure that the NHS has capacity to cope in January? Staff are already burned out and exhausted by the virus. What plans do the Government have to support our NHS to deliver the care that patients need throughout January and prevent the NHS from becoming so overwhelmed that the vaccination programme is affected?

Staff across our health service are struggling, and they know that the adversity is not over yet. I want to take this opportunity to praise workers across the NHS: our ambulance drivers, nurses, student nurses, doctors, health visitors, mental health professionals, midwives, pharmacists, porters, receptionists, radiographers, physiotherapists, admin staff and healthcare assistants. Not only that, but I want to praise the cleaners, the kitchen staff, the gardeners, the dispatch drivers, the record keepers, the chaplains, the volunteers and so many others.

When I turn up for my shifts at St George’s Tooting as an A&E doctor, I know that I am part of an NHS family in which every part relies on the others—a complex web of care and compassion. We as a country rely on them, so let us do more than offer them applause. Let us rebalance the system of wages and rewards in this country so that the most valuable people, such as care workers and nurses, are valued above shareholders and stockbrokers. I have mentioned our national character and our national health service. Both rose to the challenge admirably, but what about our national leadership? Her Majesty’s official Opposition have maintained a consistent position: we will support the Government in tackling this pandemic, but we reserve our right to scrutinise decisions and ask questions on behalf of the people. That is our proper constitutional role.

We will be demanding a full public inquiry into the Government’s response to covid-19, and one particular area that will require forensic dissection is ministerial decision making on procurement. On 18 March 2020, the Cabinet Office issued guidance on public procurement of personal protective equipment and other equipment to tackle the pandemic. That guidance noted that public bodies were permitted

“to procure goods, services and works with extreme urgency.”

By 31 July 2020, more than 8,600 contracts had been awarded, with a value of £18 billion.

Of course we recognise that there was a need for speed, but the National Audit Office reported that there is

“a high-priority lane to assess and process potential PPE leads from government officials, ministers’ offices, MPs and members of the House of Lords”.

Many suppliers with connections to the Government and Ministers obtained lucrative contracts. One such supplier was PestFix, a vermin control company valued at just over £19,000, which was given a contract worth £108 million for PPE that had not been properly tested. The House has heard of the case of Mr Gabriel González Andersson, who was awarded more than £20 million as a middleman between the UK Government and a PPE business founded as the pandemic took hold by Michael Saiger, a Florida-based jewellery designer. And the NAO showed that Stroud Conservative councillor Steve Dechan, who ran a small, loss-making firm, signed a £156 million deal to import PPE from China.

Those are just a few instances of a procurement scandal that will only grow as more of the truth emerges. The Prime Minister says over and again that any Government would have done the same. He is wrong. He must not judge others by his own standards. This is a Government who have stretched the procurement rules to breaking point, overseen a bonanza for chancers, spivs and Del Boys, and wasted millions on the cronies and chums of Government insiders. Doctors and nurses were sent to the frontline without working PPE while profiteers lined their pockets. The truth will come out. The public will get the answers they demand, and the guilty men and women—the hard-faced men who have done well out of the pandemic—will be called to justice.

Now, we face the first Christmas alongside covid-19. Ministers must do more to explain the science behind their current plans for the tier system and their plans to relax the rules during Christmas. The PM says we must be “jolly careful”, but are his Government? Is the Minister aware of the advice of Professor Andrew Hayward, director of the University College London Institute of Epidemiology and Health Care and a member of the Scientific Advisory Group for Emergencies, who told the BBC that allowing people to meet up over Christmas amounted to

“throwing fuel on the Covid fire”

and that it would

“definitely lead to increased transmission”

and was

“likely to lead to a third wave of infection, with hospitals being overrun, and more unnecessary deaths”?

Is the Minister confident that the Government have done everything possible to avoid a third wave in the new year?

With today’s announcement that London will be moved into tier 3 just a week before rules are relaxed, is the Minister confident that the Government can effectively communicate these three rule changes to the public in the next week? What assurance can she offer the millions living in London and the south-east of England who will be under the tier 3 rules on Wednesday that the measures taken will actually halt the spread of the virus and keep them and their families safe over Christmas?

[Steve Brine (Winchester) (Con)]

I have expressed my concerns in the House before about the Christmas policy. There is a lot of care going into looking at the data for the review of the tiers, and yet weeks ago, the Government announced a five-day relaxation starting on 23 December. What is the position of the official Opposition in respect of the Christmas firebreak? Do they now oppose that, are they still supportive of it, or are they abstaining?

--- Later in debate ---

[Dr Allin-Khan]

Everything has to be evidence based. We in the Opposition have been labouring under the misapprehension that the Government have control over the messaging that has been going out. The mixed messaging relayed day after day by this Government has left people utterly confused. That is why I am saying that we need assurances from the Minister and the Government that the millions of people living under these restrictions will in fact be safe over the Christmas period, were families still to mix.

Finally, we turn to the bright light at the end of the darkest of tunnels: the prospect of a vaccine. I welcome the news of new vaccines, and I praise all the teams who delivered them and the Medicines and Healthcare Products Regulatory Agency for its efficiency. We all have a duty now to explain that vaccines are safe, vaccines work, and if and when people are offered one, they must get vaccinated. When I am offered the vaccine, I will eagerly join the queue, not just because I am a doctor but because I have seen the tragic consequences of this disease up close. All of us in this House must speak up for the science and against irrational conspiracy theories and malign myth making, and we must get our people vaccinated.

Is the Minister satisfied that the Government are doing enough to build public confidence in the vaccine? Is she confident that we have the infrastructure to roll out the largest ever mass adult vaccination programme? What about those in tier 3—people in Derby, Leicester, Nottingham, Tyneside and Teesside, Lancashire, Manchester, Birmingham and the Black Country, Hull, Yorkshire, Bristol and, soon, London? Will they get the vaccine quickly and efficiently? What plans have the Government made to deliver the vaccine for tier 3? Can the Minister update us on the position of vaccinations for people in care homes? People were promised a vaccine, and they need reassurance that they were not given false hope.

As we near the end of a terrible year, let us reflect on the strength, resilience and genius of our constituents, on the communities that came together, on the values of solidarity and compassion that unite us and on our common resolve to make 2021 a better year for all—especially the bereaved, the lonely, the vulnerable and the people who saw their worlds turned upside down by this terrible disease. They deserve a Government on their side, yet millions feel let down and left on their own. In 2021, that must change.

Deaths in Mental Health Care

Rosena Allin-Khan Excerpts

Monday 30th November 2020 Westminster Hall

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is a real pleasure to serve under your chairmanship, Mr Stringer, and an honour to respond on behalf of the Opposition in this profoundly moving and powerful debate. I thank my hon. Friend the Member for Hartlepool (Mike Hill) for securing the debate, but it goes without saying that every contribution today has been extremely powerful. Everyone who has spoken has stood up for their constituents and represented the issues very well. The points have been made clearly and concisely, and hon. Members have done Melanie Leahy and the other families very proud.

We are here today because of a mother’s love for her son and her desire to receive some answers about his tragic and untimely death. It is fitting, then, that the debate should take place ahead of National Grief Awareness Week. Matthew Leahy was just 20 years old when he was admitted to the Linden Centre in November 2012 after being detained under the Mental Health Act 1983. While in the care of North Essex Partnership University Trust at the Linden Centre, Matthew phoned his parents on numerous occasions to express his unhappiness at being detained there. I know that I am speaking again of things that have already been mentioned, but it is important to give the details as many times as possible, to get what happened across as powerfully as is necessary to see the change we want.

Two days after being admitted, Matthew phoned his father to tell him that he had been drugged and raped on the ward. Following a 999 call made by Matthew, the Linden Centre staff gave assurances to the family that he was indeed safe in their care. Just days later, Matthew was found unresponsive and hanged, in his room. He was transferred to Broomfield Hospital, where he was pronounced dead. Matthew was in the Linden Centre for just seven days.

As a mother myself, I cannot comprehend what Melanie has had to contend with over the last eight years. Sadly for Melanie and the family, the struggle is not over. An inquest concluded with an open narrative verdict that Matthew was subject to multiple failings and missed opportunities over a prolonged period of time, by those entrusted with his care. Multiple investigations and reviews were carried out into the North Essex Partnership University NHS Foundation Trust, and into Matthew’s care, and they raised even more questions about the care that he received and the nature of his death. I want to raise some of the concerns that were found in the various reviews so that everyone here can get further understanding of the scale of the challenge that Melanie and her family have faced for the past eight years.

At post-mortem, traces of the drug GHB were found in Matthew’s system. He had bruises just above both ankles and four to five unexplained needle wounds in his groin. Matthew’s paperwork was incomplete and a key worker was not assigned to him. Staff at the Linden Centre had not issued Matthew with a care plan, but after his death they falsified one and backdated it. A number of ligature points in the Linden Centre previously identified for removal were still there. Essex police dropped a corporate manslaughter investigation into the deaths of 25 patients who were in the care of the North Essex partnership trust at nine separate establishments since 2000. The ombudsman investigated, and agreed that Matthew had not been responded to appropriately after reporting a rape, as well as that the Essex partnership’s investigation of Matthew’s death was inadequate. All this in eight years—the toll it has taken on this family. That is before we consider the prosecution of the Essex Partnership University NHS Foundation Trust by the Health and Safety Executive following the deaths of 11 patients in its care between 2004 and 2015.

The loss of multiple lives and the tearing apart of families were devastating and, most tragically, utterly preventable. We have to learn from those tragic losses so that no other families are affected. I ask the Minister if she will please work with Melanie Leahy on this matter directly, as her predecessor promised to do. I had the honour of speaking to Melanie ahead of the debate. This is her day, Matthew’s day and a day for all who are still seeking answers about their loved ones’ deaths.

The strength it takes to continue this fight after eight long years is commendable. My heart goes out to Melanie’s family and to all who have lost loved ones in similar circumstances, not just at the Linden Centre but in care settings across the country where they were meant to be safe. Many of those people have been mentioned in today’s debate, and I thank Members again for their contributions.

A system is not working properly if it takes so long to investigate such a tragedy, and yet answers are still not forthcoming. A grieving mother should not have to plead with people to sign a petition to get answers surrounding her son’s death. There should be no barriers to the truth. Inquiries and investigations should not be reserved for the most privileged and those who are most familiar with the system.

On the point about time, I highlight that it has taken over a year to have this debate following Melanie’s successful petition. We all understand the mitigating factors that this year has brought, but I would like everyone to consider how every step of the process has been slow. Barriers have been put in place for the family at every single turn.

[James Cartlidge]

Does the hon. Lady agree that, that being so, it would be very much in the interests of all stakeholders if the inquiry took place, ideally, as soon as possible?

[Dr Allin-Khan]

Yes, of course it would be in everyone’s best interests for the inquiry to take place as soon as possible. After all this time, Melanie deserves some answers. I support her call for a statutory public inquiry into Essex mental health services and for the appointment of an independent chair. It is crucial that lessons are learned from Matthew’s case.

I will take this moment to read a few words from Melanie about why a statutory public inquiry is so important to her:

“To come this far and then get fobbed off with a review or general inquiry…would simply take…us all back to square one.”

She goes on to ask that the Minister do something real and meaningful that paves the way for truth, justice, accountability and change. There is an opportunity here for the Minister to commit to providing a grieving mother with answers about her son’s death, and to learning lessons so that other families do not suffer in this way. We cannot, and must not, delay any further.

[Graham Stringer (in the Chair)]

We have plenty of time, but I ask the Minister to leave enough time for the wind-up at the end.