Draft Coronavirus Act 2020 (Expiry of Mental Health Provisions) (England and Wales) Regulations 2020
Rosena Allin-Khan Excerpts(4 years ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
It is a pleasure to serve under your chairmanship, Mr Davies.
The removal of these provisions from the Coronavirus Act is, of course, extremely welcome, and Labour Members will not seek to oppose it. When the Coronavirus Act was hastily drafted and enacted in light of the threat our country was facing in March, we accepted the inclusion of these regulations, to be used only as a last resort. It is a relief that the provisions have never had to be used, and we are pleased to see them dropped.
The legislation represented a significant reduction in the safeguarding of individuals subject to the Mental Health Act, and I am sure that the expiration of the provisions will be gladly received by those who are living with mental ill health and by their families. I thank all health and care staff for their hard work, and I am grateful for the work of the CQC and NHS England, whose response to the virus was robust enough that the provisions were never turned on.
Although the mental health provisions in the Coronavirus Act were never activated, that does not mean that the coronavirus has not had a significant impact on the mental health system in England. In March, at the very beginning of the pandemic, an additional 2,441 people were discharged from mental health hospitals. Compared with February, that is an increase of 26%. At that time, increasing bed capacity was a priority. Although it was necessary to take that step where it was safe to do so, it was vital that discharged patients continued to receive the care they needed.
Inevitably, the redeployment of staff to concentrate efforts on tackling the virus led to disruption to existing mental health services, with surveys from charities such as Rethink Mental Illness and Mind showing that many struggled to access support during the pandemic. That was especially true for those with existing mental health conditions, including many who were abruptly discharged. The needs of people who are living with severe mental illnesses are complex, and it is vital that they receive appropriate care in all settings.
As the number of cases and hospital admissions related to covid-19 continue to rise, so too does the prospect of having to empty beds again. In August, the Government announced a £588 million fund to support the safe discharge of patients in the event that it becomes necessary to free up space for coronavirus patients. That money is essential to prevent a repeat of the mistakes that were made in March, but I had it confirmed to me last week that mental health trusts are unable to access that funding. Similarly, alongside the announcement of that money guidance was published outlining the correct procedure for safely discharging patients from hospital settings. Again, mental health trusts were excluded from that, and there is currently no equivalent guidance for them. Will the Minister please outline why mental health trusts are excluded from this vital funding, and will she confirm what resources are being made available to trusts to support the safe discharge of patients and ensure that they receive ongoing care in the community?
Concerns have also been raised about patients who were not discharged. Many mental health estates were not built with social distancing in mind, and that has affected treatment and access to visits on and off site. Reduced contact with family and friends has undoubtedly had an effect on in-patients. Staying in a mental health ward can already be an extremely lonely experience, but the extra restrictions on social contact mean that it can feel truly, devastatingly isolating. Although many people accept that digital solutions are necessary, their success in such settings has been mixed. In-patients have stated that when social contact was facilitated virtually, it made a positive difference to their experience; however, when treatment was provided through digital means, many felt that the standard of care dropped.
It is important to remember that a large number of those who have lived in mental health wards throughout the pandemic are children who are living with severe mental health disorders, such as eating disorders or severe depression. They need a more intense level of care than would be possible in the community, but that does not make the experience any less traumatic for a child. The Children’s Commissioner found that there was a great deal of resilience on those wards throughout the pandemic, with staff working exceptionally hard to ensure that the standard of care and support provided to the children did not drop, but significant challenges remained. Although staffing rates stood firm in many children’s wards, visits from external professionals dropped alarmingly throughout the pandemic. The disruption to mainstream education filtered its way into hospitals, with many teachers stopping all face-to-face teaching on the wards, which left untrained hospital staff to deliver teaching in addition to caring for patients.
During this second spike of the virus, it is crucial that all mental health in-patients receive appropriate, high-quality care. Will the Minister outline the measures that are in place to ensure that people in mental health hospitals will receive the best care available to them, despite ongoing pressures from the coronavirus?
Entrenched inequalities in mental health treatment and access to services have existed for many years, but they are undoubtedly being deepened during the pandemic. The disproportionate impact of the virus on black, Asian and ethnic minority communities has put them at greater risk of developing mental health problems. That is especially concerning, because historical racism and experiences of inappropriate support have left many individuals from BAME communities distrustful of mainstream health services, highlighting the need for support in the community. Distrust should not come as a surprise to the Government, considering that in 2019-20 the rate of detentions in England under the Mental Health Act was more than four times higher for black or black British people than it was for white people. The racial disparity in detentions under the Mental Health Act underlines the need to address health inequalities and to ensure that provision is widely accessible and that support is suitable for all. I would be grateful if the Minister outlined what work is being done to address the inequality.
We need to be clear that for many people, community support is the most effective way to improve their wellbeing, and that has to be a priority as we look to the recovery period. What work is being done to strengthen mental health support in the community at this time?
The impact that covid-19 has had on the wellbeing of the nation has been profound. The Centre for Mental Health found that approximately 10 million additional people will require some form of mental health support as a result of the pandemic. It is important that the Government recognise the additional need and have a strategy to address it during winter and beyond. We know that the best mental health strategies are proactive and preventive. Early intervention is key to addressing mental health concerns before they develop into something more insidious. The Government must ensure that services are prepared and have the resources to cope with any rise in demand.
The expiration of the provisions today is a small but welcome step in ensuring that patients who rely on safeguards in the Mental Health Act are adequately protected. I urge the Government to not stop there. The next step must be to publish the long-awaited White Paper on the Mental Health Act and to stand by their commitment to reform the legislation to better support people who are subject to it. Only then can we be confident that those living with severe mental ill health will be properly supported by the system that is designed to protect them.
Oral Answers to Questions
Rosena Allin-Khan Excerpts(4 years ago)
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Jo Churchill
I would like to thank the hon. Gentleman. In the main, many of our frontline operators are getting it free—social care, general practice, dentistry, optometry and so on. The relief was designed specifically to relieve the burden of VAT on sectors particularly affected by coronavirus while supply did not match demand. Now the Government are able to supply covid-related PPE across all sectors, the burden of VAT will still not fall on frontline providers for all covid-related PPE and demand will be met. Most businesses that make taxable supplies can recover the VAT that they incur on purchases of PPE as business expenses. They will therefore be able to reclaim all VAT after the 31st. But I reiterate: for the majority of frontline healthcare, it is free.
Dr Rosena Allin-Khan (Tooting) (Lab)
The price of an FFP2 mask bought by the Government increased by 1,400% in just six weeks to the end of May and gowns by 350%. I welcome all efforts by the Government to procure PPE, but I have concerns that we may not be getting a fair price. One company, PPE Medpro Ltd, was given Government contracts worth over £190 million. PPE Medpro Ltd had no previous experience and coincidentally was only set up on 12 May 2020. Reports have suggested that the company has substantial links to Conservative party donors, so can the Secretary of State or the Minister categorically assure the country that no Conservative party donors are profiteering from the pandemic?
Jo Churchill
Our plan on PPE has to be to stabilise the system and build resilience. That was outlined in the PPE strategy published on 28 September. [Interruption.] Children! Thank you.
Covid-19
Rosena Allin-Khan Excerpts(4 years ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
On this day of remembrance, I pay tribute to all those who made the ultimate sacrifice so that we can stand here today with the freedoms we hold dear. And I would like to formally put on the record my congratulations to President-elect Joe Biden and Vice-President-elect Kamala Harris. We look forward to working together to tackle this global pandemic.
We have heard today that the UK has tragically become the first country in Europe to pass 50,000 covid-19 deaths. It speaks to why we are all here today to discuss the greatest challenge of our time. We have heard some superb speeches in the debate. I pay a special tribute to Mary Hutchins, the nan of my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy), who does her community proud. I also pay tribute to the hon. Member for Beaconsfield (Joy Morrissey), who was incredibly powerful in speaking up for Jamie and his family.
My hon. Friends the Members for Sefton Central (Bill Esterson), for Nottingham East (Nadia Whittome) and for Brentford and Isleworth (Ruth Cadbury) all rightly raised the murky world of procurement and the complete lack of transparency. My hon. Friend the Member for Warwick and Leamington (Matt Western) spoke movingly about the need to do better for those in care homes.
There is a clear sense of hope about the prospect of a vaccine. It has come at the end of a particularly bleak year that has left none untouched by the effects of the virus, but we need to ensure that this is not false hope. There must be a clear plan for manufacture and distribution. With little time to get that right, can the Minister please outline how the Government will ensure that those deemed a priority to receive the initial dose will be able to access it?
On the topic of priority groups, in June, the Health and Social Care Secretary said that the Government would consider black, Asian and minority ethnic groups as a priority for a vaccine, but that does not seem to be the case now. Why? I have seen at first hand patients in intensive care fighting for their lives because of this virus. I was overwhelmed by how many of them were from our BAME communities. Is it not possible for the Joint Committee on Vaccination and Immunisation to consider multiple risk factors when rolling out the vaccine? What about all those adults who have been shielding for months? Throughout the summer they urged the Government not to forget them. What is the Government’s message for them today?
Finally on a potential vaccine, I sincerely hope that we are successful, but if there are setbacks that mean that the vaccine is not rolled out until later in 2021 the Government must have a plan in place that is communicated effectively to the public and which outlines what restrictions may look like. I hope to see the Government planning for that scenario, so that as a nation we are not caught off-guard again by the virus.
Sadly, people feel left behind. They need to feel that they have a Government on their side. The feeling of isolation and loneliness needs urgent attention from the Government this winter. The Minister for Patient Safety, Mental Health and Suicide Prevention tweeted only a couple of days ago that mental health services have never closed, and have continued throughout, but for many, especially those who rely on group therapies, that has not been the reality.
It is important that we do not forget those who need to access mental health services for the first time and simply do not know where to turn. Our wedding industry, talented people involved in the arts, musicians, photographers and small family-run businesses feel as if no one is listening to them. The Government did them a great disservice by describing their careers as unviable—that cut to the core of who they are, the talents that they have and the way in which they give back to our economy. I have heard from people in the industries that I have mentioned who felt that the Government were questioning their viability not just in the workplace but as husbands, wives and parents. That has affected their mental health greatly. When Ministers come to the House they must take responsibility for the language that they use and understand the detrimental knock-on effects that it can have on people’s mental health. Artists, creatives and entrepreneurs need a Government who are on their side, showing them that they care not only about their livelihood but about their mental health. How will they be supported through the winter?
As the days become shorter at a time when people are missing their families and way of life, what provisions are in place for anyone who needs help with their mental ill health? What support will be offered to organisations and communities across the country that are lifelines to people who rely on them for a bit of brightness in their day? On suicide, is there a plan for a comprehensive national real-time monitoring system for suspected suicides that will allow us to monitor and respond to new concerns among particular groups of people or in particular areas of the country? I am sure, whatever side of the House we are on, we agree that this is important.
What is the Government’s suicide prevention strategy in the light of covid-19? Many people with serious mental illnesses have been feeling left out of the Government’s strategy to tackle covid-19, with research finding that people with a pre-existing mental health diagnosis were 65% more likely to be diagnosed with covid-19 than those without such a diagnosis. Will the Minister outline any work that the Government are conducting to provide assistance for people with schizophrenia, psychosis or borderline personality disorder?
Members have raised many times in the Chamber the fact that expectant mothers are suffering immeasurably because they cannot bring a birthing partner with them into hospital, whether to accompany them to tests to check on their unborn baby, or when they are giving birth. What support has been offered to those suffering from post-natal depression? Some expectant mothers and fathers have had to endure the worst and find out that they are miscarrying. What support is available to mothers who have to be told that alone, and break down on the phone trying to tell their partner or a loved one? We have to do better for those people.
What support has been offered to mental health trusts for the winter? Are they able to access funding to support the safe discharge of patients from hospital in the light of the second spike? It is crucial that this is given the attention it deserves.
I welcome the announcement of routine testing for frontline NHS staff. We have been requesting that for months, and it is an important development for not only protecting staff but infection control in healthcare settings. There have been other changes to testing, and I would like to take this opportunity to pick up on plans for the mass distribution of lateral flow tests. What resources are being allocated to the local councils that are getting access to 10,000 lateral flow tests, including in my borough of Wandsworth, to make this a success? For areas with a disproportionately high number of vulnerable groups, how will the Government address any strain on council resources?
After weeks of unnecessary delay, the Government have now addressed the need to get students home safely over Christmas, and tests will be made available. Could the Government outline how they plan to work with universities and local councils to ensure that rapid and accurate testing is available for all students who need it? How will the tests be administered, and are the Government prepared to comment on what students should do in January?
We must understand that our students have endured a particularly difficult time, with the exams fiasco, being told it was safe to go to university, arriving at university only to be made to feel responsible for the second spike of covid-19 and then being trapped in dormitories with strangers, unable to leave to do their shopping or see their families. We have to get it right for our students, who we are allowing to go home over the Christmas holidays.
We have a long road ahead, and we cannot lose hope. The Government need to get their response to this crisis right, and they do not have to spend taxpayers’ money on PR consultants to do so. For many months, brave people across the country have played their part in fighting this virus. We cannot let them down now.
Baby Loss: Covid-19
Rosena Allin-Khan Excerpts(4 years ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
It is an absolute pleasure to serve under your chairwomanship, Ms Eagle. It is an honour and a privilege to respond on behalf of the Opposition to this profoundly moving and powerful debate, which I thank the hon. Member for Truro and Falmouth (Cherilyn Mackrory) for securing. Bravery comes in all forms, and today she has shown the very best of us and done Lily proud. Lily’s honour and name will be timeless in the records of the discussions that we have had today. The hon. Member is incredible.
This is the fifth year running in which we have had such a debate during Baby Loss Awareness Week. It is becoming a very welcome tradition and long may it continue, although obviously we have heard today of the importance of ensuring that we prevent as many deaths as possible. I pay tribute to every Member who has had the courage and conviction to share their experiences on an issue as devastating as baby loss. To live through it is one thing, but to speak about it in a bid to help others is another altogether. After what we have seen today, I have never been more proud to be in this place and to stand among all Members present, regardless of party, political persuasion or geography. It is an honour to hear their stories first hand.
The fact that we cannot provide comfort to one another when talking about this, though we are compelled to, illustrates how hard it must for people going through it not to be able to have the comfort of the ones they love the most, and for some parents to have to hear the very worst news that they will ever receive in a car park or down a phone. Such debates hopefully go some way towards breaking down the stigma that sadly persists. I am sure that having the bravery to speak out on this will bring a great deal of comfort to many who have been affected by baby loss.
I wish to reflect on a few of the compelling contributions. My hon. Friend the Member for Luton North (Sarah Owen) spoke so movingly about the experience of multiple loss and was a powerful advocate for the importance of having a loved one there. She was able to draw a stark comparison between the experience of not having someone there and having someone there. We must pay attention to that powerful contribution. The hon. Member for North Ayrshire and Arran (Patricia Gibson) is no longer present, but baby Ken will be immortalised in this place through the story that she shared. I do not know how she delivered that speech, to be honest. Most people I know would not have even been able to speak those words.
I am sure that all of us send our love and best wishes to Donna, who has a powerful advocate in the hon. Member for North Antrim (Ian Paisley). I thank him for bringing her story and lived experience to this place—he has done her proud. When my hon. Friend the Member for Sheffield, Hallam (Olivia Blake) spoke, I was lost for words. That she lived through the very worst of experiences in August, in the very worst of ways and in the most difficult of circumstances and yet is here now, not even three months later, telling her story in a bid to help others represents a strength rarely found in this world. I thank her so much for all the good she is doing and the voice she is for all those who cannot have one at this time. [Hon. Members: “Hear, hear!]
The hon. Member for Strangford (Jim Shannon) showed, through his emotion, the power of the need to have something to cling on to. He has his faith. However, as he rightly explained, people also need a loved one to be there. I turn to speech of the hon. Member for Guildford (Angela Richardson)—wow. It is so important that she raised the issue of what an infection at this time could do to a woman’s body and to the ability to carry a pregnancy. Given how the hon. Member for Guildford—I want to say her name, because this feels like the sort of debate where we should—went through a horrific experience not even in her own home or own environment while having a young child and went on to experience three subsequent losses, I cannot imagine what it took to talk about that today.
The hon. Member for Meriden (Saqib Bhatti) is no longer in his place, but it was great to hear about his incredible work to raise awareness. Jumping out of a plane is testing at the best of times. The chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt), spoke powerfully, as always.
As we have heard, losing a baby is one of the most harrowing experiences a person can go through. It is painful, it is devastating, and it is ultimately cruel. It feels like the cruellest of circumstances. We know that, unfortunately, it is all too common and can happen to anyone at any time.
I am often the doctor in A&E who meets the mum when she is coming in. We have heard powerful contributions about stigma and guilt. For me, the take-home is always the overpowering sense from a mother that there is something she could have done. I want to put on the record, and say to those who may be watching, that she has done nothing wrong; she has done everything right. We must do all that we can to fight against the stigma and shame that so many women feel, going through pages and pages of internet sites, wondering, “Did I eat something wrong? Did I lie the wrong way? Should I have gone for that jog?” She did nothing wrong; she did everything right. Her baby was loved.
It is heartbreaking to have conversations like that without a partner, a parent or a best friend present. The first step supporting those affected is drawing attention to this tragic event. I am so proud of the fantastic work of the Baby Loss Awareness Alliance, a collection of more than 90 charities who work relentlessly to ensure that this is on the agenda during Baby Loss Awareness Week and beyond.
In 2020, it would be remiss not to return our attention to the effects of covid-19 when we discuss baby loss. This year of social isolation, solitude and sacrifice has made such tragic occurrences even more tragic. The coronavirus has stripped the humanity out of grieving, with a mother unable to get a hug from her mum and bad news delivered in personal protective equipment while unable to hug a grieving mother or father. We are unable to do what is so instinctively natural to us: to share our grief with those who love us as we lose someone we love.
During the pandemic, there has been reduced access to face-to-face appointments. When appointments do take place in person, partners have been excluded, leaving women to receive the worst news or make the most difficult decisions alone. That has been deeply isolating not only for mothers but for fathers as well. They have that helpless feeling of waiting on the other end of the phone, pacing the room, waiting for it to ring, and then wondering whether they are allowed to show grief, because they are not carrying the baby but they feel the loss equally. They try to be strong for their partner while a part of them dies inside. Virtual appointments just do not carry the same compassion and assurance as seeing someone in person, and as we have heard it can be especially difficult for parents who have already suffered a previous loss. There are challenges in hospital settings, too.
We cannot underestimate the impact that this has on expectant parents. I do not doubt that the Minister will talk about the work that the Government are doing to try to make this more bearable for parents who undergo such a loss. To support bereaved families, it is absolutely crucial that they receive immediate care. There is a direct correlation between when the person going through grief receives the package of mental health support and how long the need for intervention and mental health support continues. The sooner they get it, the better it is for them. Access to bereavement support varies across the country at the best of times, but the redeployment of many NHS staff in the wake of the pandemic has resulted in even greater challenges in accessing that vital support.
This is the most difficult of journeys. Very often, we cannot change the outcome, but we can influence the journey and make it more bearable. The NHS is here for parents going through this. Maternity and neonatal care must not be curtailed during the second wave of covid-19.
I thank all hon. Members for bravely sharing their experiences. I am sorry that I have spoken for so long; I did not even finish what I had planned to say, but sometimes we have to go with the moment. I could not be more proud of the contributions and to call all hon. Members here colleagues.
Ms Angela Eagle (in the Chair)
Minister, could you leave a couple of minutes before the end so that I can call the mover of the motion to reply?
Covid-19
Rosena Allin-Khan Excerpts(4 years ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
We have heard some superb speeches in this debate and a great deal of heartfelt contribution from all around the House. I always say that I believe that every single one of us came to this place to be a force for good. We all have unique challenges in our constituencies, but we strive to do the best that we can. Sadly, there are some clear patterns of failure that I need to address tonight—patterns of failure by this Government: a refusal to act, an inability to empathise and, crucially, the failure to learn.
The Government failed to get on top of this virus in the spring. They failed to act in time and by failing to learn from their earlier mistakes, they have again failed to get on top of the virus ahead of winter. In fact, on Saturday, the Minister claimed that only “a crystal ball” could have predicted the need for a second lockdown. Luckily, the Government do not need a crystal ball because they have experts, who, six weeks ago, highlighted the need for a short, sharp two-week circuit breaker—so yes, it was predicted. A crystal ball was not needed. However, this Government did not have the political will to act six weeks ago and refused to work with Opposition colleagues, instead deciding to use the health of the nation as a political football.
During the last Prime Minister’s questions, the Prime Minister stated that he did not believe a national circuit breaker was the right policy for the country. A couple of days prior to that, the Health Secretary stated that a more targeted approach would get a grip on the virus and that a national circuit breaker was
“not the policy of the Government”.—[Official Report, 19 October 2020; Vol. 682, c. 784.]
It was clear at the time that this was the wrong approach and was at odds with the scientific expert advice on offer.
The Prime Minister has now warned of deaths twice as high over winter as they were in spring—sobering indeed—yet six weeks ago, the chief scientific officer was warning of the worrying forecast of daily cases. Why, then, did the Government choose to rule out so steadfastly measures that would save lives? Can they not see the damage and miscommunication that this causes? People were laid off last week as businesses anticipated the end of the furlough scheme, only for it to be extended on Saturday night. What is the Government’s message to all those people who have just lost their jobs?
Without a functioning test, trace and isolate system in place, there can be no way out of this crisis. The Government have had seven months to get on top of testing, yet the covid app does not work for the hundreds of thousands of people in England and Wales whose phones are set to unsupported languages. For those people, the app simply shows a blank screen. That does not promote confidence among the British people that the Government can get on top of tracing, and Serco is still failing miserably at tracing contacts adequately. The Government have had seven months to correct the situation. Understandably, this epidemic is unprecedented and, understandably, there are things that could not have been foreseen, but the Government have had seven months to rectify the situation and should and could have done better.
The Government’s continued flip-flopping on scientific advice breeds uncertainty. We have heard in the Chamber tonight Members from all parties talk of community uncertainty and of businesses that do not know whether they will ever be able to survive again. People from the wedding sector, people who run small gyms and people who work on golf courses want answers. They are just good people, trying to earn a living and wanting some certainty.
Mr Steve Baker
I do not know whether the hon. Lady has noticed, but scientific experts, even in the same field of epidemiology, quite often disagree profoundly. I wonder whether Labour has noticed that and what it plans to do about it. If the hon. Lady is looking for any ideas, I have tweeted out a summary of a book on the subject.
Dr Allin-Khan
I thank the hon. Gentleman for his contribution and I congratulate him on his ability to tweet. I have a master’s in public health and am perfectly capable of understanding that the very eminent scientists who work as advisers to the Government are doing an incredible job. They were selected to work for the Government so that the Government could take their advice, and they have advised the Government that a two-week circuit breaker would have been beneficial, both to the economy and in respect of saving lives, had it been implemented weeks ago. I am pleased that the hon. Gentleman has the ability to tweet out information about a book; I will continue to read my books on epidemiology with great joy. [Interruption.] If he would like to intervene again, I shall take another intervention.
Dr Allin-Khan
I have engaged with such serious subjects when undertaking all four of my science degrees.
Speculation that self-isolation could be reduced from 14 to seven days does nothing to clarify how people can keep their families safe. [Interruption.] I am enjoying hearing the chuntering; I would welcome anybody who wished to intervene on me because I am well up for it, as they say in Tooting. I do enjoy debates—in fact, I would welcome debate, because what always happens is that I make my comments from the Dispatch Box, sit down and listen to the Minister, for whom I have a great deal of respect, but then I have no ability to intervene, so bring it on.
The resilience that British people have shown over the past seven months has been remarkable. In the face of uncertainty and fear, our communities have come together to support one another time and again. Like everyone in the Chamber, I am so proud of all those who helped to deliver food and medicines to our most vulnerable at the height of the crisis, and I have been incredibly moved by all those businesses, struggling themselves, that provided free school meals locally when the Government failed to act. It touches me to witness the hope and humanity of our communities and of individuals such as Marcus Rashford, but it is shameful that that has been necessary as a result of this Government’s actions.
It breaks my heart that more children than ever will know the taste of hunger in 2020 and that they will feel the cold that comes from their parents being unable to pay the bills. The last Labour Government lifted more than 1 million children out of poverty. We need more action like that, not Conservative Members blaming chaotic parents for child hunger, alleging that free school meal vouchers go direct to crack dens and brothels, or spinning the narrative that it is the sole responsibility of local communities to ensure that no child goes hungry. Where is the compassion and humanity from the Government? I hope we do not have to continue asking ourselves that question throughout winter.
Certainly, across our communities, compassion and humanity are in no short supply among our frontline health and care staff—on that we can all agree. Those frontline staff have been placed in an impossible situation throughout the year. Will the Government commit to ensuring that those staff have adequate levels of PPE across the winter, and will they commit to frequent testing of our frontline staff, who put their lives on the line day in, day out? The impact of the neglect of our NHS staff is that almost 2 million days were lost to mental ill health during the first wave of the pandemic. I fear the effects of the second spike this winter. We can stand on our doorsteps and clap, but why can we not give them the support they truly deserve?
Will the Minister agree to meet to discuss our care for carers proposal to address the mental health needs of our 3 million health and care staff? Will the Minister agree to meet me to discuss the care for carers plan? Will the Minister agree to work cross-party together to support our frontline NHS and care workers?
Ms Dorries
Obviously, I cannot answer from a sedentary position. On the care package, the hon. Lady will need to meet another Minister, but I will take her request on. I am the Minister for mental health, not for care workers, but I will pass that on for her.
Dr Allin-Khan
It is a package of mental healthcare for our frontline NHS and care workers, which I am sorry the Minister seems to have forgotten. I have raised it a number of times. Is she agreeing to meet me to discuss the care for carers mental health package for our frontline NHS and care staff?
Ms Dorries
I will provide a detailed explanation of what we are doing for frontline workers in my own speech.
Dr Allin-Khan
I take that as a no. I give the Minister the opportunity to give me a straight yes or no answer. Will she kindly agree to meet me to work cross-party together for the betterment of the mental health of our frontline NHS and care staff—yes or no?
Ms Dorries
Madam Deputy Speaker, this is a rather unusual way of closing a debate. We have a very comprehensive package in place for key workers, which has been provided by the NHS, and I am happy to detail that when I give my closing speech.
Dr Allin-Khan
I am very familiar with the detail, which the Minister uses every single time we have a debate, but I will take that as a hard no and continue with my speech.
For the mental health of people across the country—[Interruption.] The policy is very clear. The Minister is chuntering from a sedentary position; would she like to intervene?
Madam Deputy Speaker (Dame Eleanor Laing)
Order. [Interruption.] Yes, I appreciate what the hon. Lady is saying. I think this exchange has run its course, and I am sure that she is probably about to come to her conclusion.
Dr Allin-Khan
Thank you. As I said, I take that as a hard no.
For the mental health of people across the country, the Government have to address questions that they were slow to answer in spring. For those who rely on sport for positive mental health, will the Minister outline the options open over the coming month? For those with loved ones in care homes, will a new testing and visitation policy be implemented? Where staff are redeployed, will the Minister outline what support will be offered? For those who have lost loved ones to covid-19, what specific mental health support will be offered? Students across the range of education need support, especially those in university. What extra support will be in place for them? I look forward to the Minister’s replies to those questions in her closing remarks.
We are only in November and we face a cruel, long winter. The public want to support the Government’s measures and see the back of the virus, but people also want reassurance that our nation’s mental health will not be put at risk. The years of underfunding of mental health leave us without much faith. We called for a national wellbeing guarantee last month. The Government should have addressed that weeks ago. Now, it is crucial and I plead with the Minister to meet the sector properly and get a plan in place urgently.
It may feel impossible to hope on the edge of a precipice, as we are, but the kindness on display across the UK should bring hope to us all. We continue to extend the offer to work together through the crisis for all our communities. We just need the political will from the Government.
Covid-19
Rosena Allin-Khan Excerpts(4 years, 1 month ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
We have heard some superb speeches in this debate, but due to limited time, I cannot personally refer to them all. We have heard stories from every part of our nation, of the heroism of our NHS workers, of the stoicism and resolve of the British people, and of the tragedy and loss caused by this cruel disease. But there is something else too: a growing sense of frustration, a loss of confidence and a lack of trust in this Government; a feeling that decisions are guided by politics and public relations, not by science and evidence; and a sense that many sacrifices have been in vain, and that the current strategy has all the pain but so little gain.
We heard in Prime Minister’s questions yesterday that there is no clear route out of the tier 3 system if the R remains above 1. We have seen Ministers in broadcast studios squirm as they try to explain byzantine rules to an increasingly bewildered public. We have seen advisers flout the coronavirus rules while calling for stiffer penalties for the rest of us. We have heard the cries of anguish from hospitality and events, retail, the arts, aviation, small businesses, the wedding sector and 3 million freelancers excluded from any support. Job losses mounting; young people’s education in chaos; students treated like prisoners; a crisis in our care homes; people scared for their future; and, all the while, the number of infections rising, hospital admissions rising, the death toll rising.
The Government’s strategy is not working. Winter is coming and we all understand the pressure that winter places on our NHS. I know from serving on the NHS frontline that winter is the cruellest season, from slips to falls to flu to loneliness to hypothermia to respiratory diseases to depression and other mental health conditions triggered by these darkening days. Now we are piling on the huge pressures from covid-19. There is a real risk that, just as Ramadan as well as the Jewish high holidays were disrupted by covid restrictions, so too will Christmas be on the line. After this terrible year, people deserve to know whether they can spend Christmas with their families; whether they can hug their loved one in a care home for what may be their last Christmas. The Government have shown that they are willing to take free school meals from the mouths of children. Surely Ministers do not want to steal Christmas as well?
A harsh winter without respite will hit the nation’s mental health and it will hit it hard. I have heard from the Samaritans that many, many more young people are struggling. Self-harm among women has increased. Older people are isolated. University College London reported that after a month of lockdown, nearly a fifth of people had thoughts of self-harm and/or suicide. The charity Rethink says that 79% of people with an existing mental health condition have experienced it getting worse. Mind found that a quarter of people trying to access mental health services were simply unable to do so. Mental health services, especially child and adolescent mental health services, were stretched to the limit before covid. Now they are being pushed over the edge. I hear every day from teachers in schools and desperate parents crying out for help from CAMHS, but who are unable to get on the waiting list and unable to get help. A new report out today highlights that one in six children have been identified as having probable mental health illness, increasing from one in nine in 2017. One in six children—that is staggering.
We know that covid is having a marked impact on our children and young people. We know the impact on people in abusive relationships. We have heard about the impact on cancer patients, on people with addictions, on people and families in prison, on people waiting for operations or diagnostic tests. We know the waiting times in A&E have increased nationally. The fact is that we are storing up a huge public health crisis that will last well beyond the last case of covid-19. NHS staff are exhausted. I have seen tears of desperation, of frustration, of rage, of exasperation and, now, of disappointment that the Government are not listening to frontline workers and their pleas.
Just today, the NHS absence rates for June were published. Alarmingly, 32% of all sickness absence in the NHS in June was for mental health reasons, up 3% from May. Mental health-related absences were three times higher than covid-related sickness at that time. Frontline workers have had to bury their colleagues. They have had to deliver the most painful of news and be the last point of call for so many of their patients. They are suffering immeasurably, so many of them, with post-traumatic stress disorder. All they are asking for is some timely help before it gets so unmanageable that they cannot manage their own lives and their families, and have to be off long-term sick. We owe them that at the very least. Every month, I highlight the growing absences and tell the Government that they should serve as a wake-up call, but clearly they just keep hitting snooze. We must ease the pressure, care for our carers and pay them properly.
The track and trace system is failing, so let us get rid of the private consultants and let the public health teams take over. The tier system is confusing, it is unfair and, seemingly, without a way out. It wrecks our national unity. The Government have been pitting Mayor against Mayor, business against business, region against region. It has to be fair. That is why the Labour party is calling for a national circuit breaker. As the Government’s own scientific advisers say, it would save up to 7,000 lives and halve admissions to hospital. Two to three weeks to curtail this disease, followed by the real prospect of a Christmas as close to normal as possible.
This House has heard many great clashes of ideology over the centuries, but this is not one of them. This is not the time to be playing politics with people’s lives or their livelihoods. This is the time to listen to science, reason and evidence, and to show humanity. There is no shame in the Government reversing their position, even at this late stage. There is no burn in a U-turn. I tell Ministers that the Opposition will support them, the nation will applaud them and history will judge them well if they announce a circuit breaker this afternoon. It is time to do the right thing.
Mental Health Support: Frontline Staff
Rosena Allin-Khan Excerpts(4 years, 1 month ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
It is indeed a pleasure to speak for the Opposition with you in the Chair, Ms McDonagh. I thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for securing this extremely important debate and other hon. Members for their thoughtful contributions. I pay tribute to all staff on the frontline, far too many of whom have made the ultimate sacrifice while trying to keep us safe and well. Their unwavering courage in standing up to the virus, knowing full well the risks to themselves and their families, has been inspirational and truly deserving of the gratitude of Members across the House.
From the very beginning of the pandemic, health and care staff have made immense sacrifices. When we were asked to stay home to avoid the virus, they were going to work and facing it head-on anyway. They were sadly left unprepared, with PPE problems and no access to testing that lasted for months. Ahead of World Mental Health Day on Saturday, this is a fitting time to acknowledge that frontline staff have a unique need. Everyone across the country has had their life disrupted, but our frontline health and care staff have had to deal with patients, colleagues and friends dying on their watch. As the hon. Member for East Kilbride, Strathaven and Lesmahagow said, nothing prepares you for losing a colleague, particularly when you think it could have been avoided. Frontline staff are trained to deal with high-pressure scenarios, but even then, they were not trained to tell people that their loved ones had died via phone calls. Covid-19 has stripped the humanity out of grieving.
The additional pressure has undoubtedly had a significant impact on the emotional wellbeing of frontline health and care staff. They have had no break, no support and no relief from the Government. Fatigue and burn-out are setting in on an already exhausted workforce, who are in desperate need of respite. We need only look at the latest NHS staff absence figures to grasp the true magnitude of the hidden crisis. Over half a million sick days were taken by NHS staff in England because of mental ill health in May alone—one month. Half a million days in just one month.
For context, those absences account for almost a third of all NHS absences for the month of May. In comparison, 200,000 fewer sick days were taken for covid-related illness during the same time period. Let us remember that it was around that time that the virus was causing the most damage to our country, when hospital admissions were still high and transmission was rampant. Even then, for NHS staff, mental ill health still accounted for more time away from the frontline than any other reason. A survey conducted by NHS Providers of its membership at the tail end of June showed that 92% of NHS trusts were concerned about staff wellbeing, stress and burn-out following the pandemic.
The evidence is clear. If we are to expect NHS and care staff to deal effectively with an impending second spike in addition to the care backlog while approaching winter flu season, they must receive mental health support. They need it tailored for them. All health and care staff have given their all. Many have been redeployed, have been working in fear without adequate PPE, have lost colleagues or members of their own family, and have never been trained for something like this. The Government need to act. They cannot simply cherry-pick who they are going to support.
Just as Ministers have an obligation to protect the physical wellbeing of frontline staff by providing them with PPE and ensuring that their work environments are as safe as possible, they also have an obligation to protect the mental wellbeing of frontline staff, guaranteeing them access to psychological therapy if and when they need it, and need it they certainly do. It should be a moral imperative for this Government to ensure health and care staff have the practical and emotional support they need to do their jobs. Based on what little support they have been offered so far, it does not seem like it is.
It is not as if the Government have not had ample opportunities to address the growing need. Labour recognise it and we have put forward our own plans to support the mental health of the entire health and care workforce. Our care for carers package, which we launched in June, would have guaranteed access to counselling and psychotherapy to all 3.1 million health and social care workers. It would be offered nationally and completely confidentially. Currently, that is not available to the majority of the workforce. The package was designed in consultation with those on the ground—nurses, paramedics and porters—who are leading the fight against coronavirus. The Labour party has said that not a single frontline worker in our NHS or care workforce will be left behind. Everybody is equally valuable.
I want to share a couple of testimonies. During our consultation, an ambulance worker and member of the GMB trade union said:
“My team of ambulance staff have lost a close colleague to Covid, as many have in the nursing and care sectors. Every death is tragic. The stress on the team, the issues of grief and loss, the fact that it could have been them, for some survivors guilt, it has had a big mental health impact…I worry about my colleagues and future patient care.”
Care home workers were just as fraught. One told me:
“It has been really emotionally hard supporting residents when they are dying without their loved ones close by. Then we have had to support and reassure their family members and provide information about their last moments. There’s a lot of questioning going on—could I have done more, could anyone have done more, were the residents’ lives valued in the way we would want them to be?”
She continues:
“I am a really strong positive person and I have been a carer for over 15 years. But at the moment I really don’t think I could mentally carry on if there is another wave of Covid, I just don’t think I would have the strength to go through it again. There is definitely going to be a mental health crisis in the care sector.”
Those types of testimonies are sadly far too common. Staff are desperate for help, yet nothing has been forthcoming from this Government. Care for carers would have given the workforce the support they need, yet in June, when I requested a meeting to discuss the proposal, the Health Secretary and the Minister responding today refused to meet me. Given the sheer scale of the problem, I ask the Minister whether she will meet me to discuss the care for carers package, so that together, with a cross-party, conciliatory approach, we can give our frontline care and NHS workers the mental health support that they need. I hope she will reconsider the offer.
Ahead of winter and a second spike, the Government must learn the lessons of the spring. We must fight for the mental health of those who have supported us so courageously during this crisis. Just last week, the Centre for Mental Health predicted that 10 million people across the UK will need mental health support as a consequence of covid—8.5 million adults and 1.5 million children. If we are ever going to be in a position to match that need, we need to first protect the mental wellbeing of our healthcare workers. Only then, if we do that thoroughly and fairly, can we expect them to protect the physical and mental health of the nation. I hope the Minister agrees that without the proper resources being made available to our frontline staff, we risk further damaging the health of our country.
Oral Answers to Questions
Rosena Allin-Khan Excerpts(4 years, 1 month ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
It has been six months of uncertainty for our country’s children and their parents, with schooling cancelled, the exam results fiasco and now students trapped in uncertainty in their university accommodation. Despite the Education Secretary recognising that there was a serious impact on young people’s mental health, yet again it seems that the Government have no plan. Children and young people are being failed. When will the Minister finally address the pending mental health crisis in our schools, colleges and universities?
Ms Dorries
I just do not recognise the picture that the hon. Lady has presented. We are investing at least £2.3 billion in mental health support and mental health provision. That investment translates to 345,000 children and young people who will be able to access mental health support via NHS-funded health services and school-based mental health support teams. Spending on children and young people’s mental health services is growing faster than the overall spend on mental health, which itself is growing faster than the overall NHS budget. Children and young people’s mental health is our priority, and we are showing that by investing in it. The picture that she paints is, I am afraid, completely not the case.
Health Protection (Coronavirus, Restrictions) (Blackburn with Darwen and Bradford) Regulations 2020
Health Protection (Coronavirus, Restrictions) (Blackburn with Darwen and Bradford) (Amendment) Regulations 2020
Health Protection (Coronavirus, Restrictions) (Blackburn with Darwen and Bradford) (Amendment) (No. 2) Regulations 2020
Health Protection (Coronavirus, Restrictions) (Blackburn with Darwen and Bradford) (Amendment) (No. 3) Regulations 2020
Rosena Allin-Khan Excerpts(4 years, 2 months ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
It is always a pleasure to serve under your chairmanship, Sir David. I will start by saying that Labour Members will not oppose the regulations. Keeping people safe and preventing the spread of the virus remains the No. 1 priority, and Labour Members will always support regulations that aim to achieve that. It is important, however, to consider the impact that the regulations have already had and will continue to have on those living in Blackburn with Darwen and Bradford.
The national lockdown, necessary as it was, led to a period of social isolation unlike anything many of us have experienced before. The mental health impact has been profound, with rising levels of loneliness, depression and anxiety across the country as a whole. When the restrictions were slowly lifted, it was not only a relief for many of those struggling with their mental health, but a lifeline. Although targeted local lockdowns ensure that the difficulties experienced by individuals affected are not spread nationwide, that does not make their sacrifices any easier.
Mothers are having to give birth on their own. Within the regulations there is reference to circumstances whereby individuals can attend a person’s giving birth, but what has the reality been? Can the Minister tell me how many women locally have given birth on their own? Not being able to visit loved ones is not easy at the best of times. In a period of a public health crisis and economic uncertainty, with no real end in sight, the toll is significantly greater. That is why the people of Blackburn and Bradford need all the support that they can get from their Government. What additional resources are being offered to support the wellbeing of those in the affected wards?
People who rely on others for deliveries, shopping and care needs have been understandably worried. I completely understand that the specific set of restrictions imposed by these regulations was designed to avoid a more severe economic lockdown that could potentially create more problems than it solves. However, those decisions must be made in full partnership with local authority leaders and public health experts on the ground.
Communication is key if local lockdowns are to be effective. Will the Minister explain how the decision was made to restrict socialising, rather than economic activity, and outline how that was agreed with local leaders at the time? It would be useful to know how regular the communication with local leadership has been throughout the time when the regulations have been in place.
It is local people who need to abide by, enforce and live with the regulations; they cannot be sidelined in the decision-making process. They need immediate, clear and decisive communication from central Government so that they can act to address increases in case numbers before they become unmanageable. That process must be completely transparent and should be a partnership involving working together to keep people safe, not something announced by Ministers at the last minute without engagement.
It would be foolish to presume that the regulations have not had economic consequences. With households forbidden to socialise with others, local pubs and restaurants have been experiencing much lower footfall than normal. The hospitality industry has already been decimated by covid-19, and such local restrictions make it even more difficult. That is not to say that the restrictions should not be brought in. However, the businesses in question must be adequately supported.
I understand that the Government have taken steps to provide significant support to businesses and workers since the beginning of the pandemic, but with the winding down of support schemes in the next month, the future of many local businesses and their employees is desperately uncertain. Will the Minister please outline what additional targeted economic support, in addition to the national measures already in place, is being offered to areas with local restrictions to ensure that they do not fall behind the rest of the country during the recovery?
As we have said since the beginning of the pandemic, lockdowns are effective in preventing the spread of the virus only to a certain extent. They are short-term measures that bring a host of economic, social and mental health problems, and without an effective test and trace strategy coinciding with them they cause just as much harm as good.
Mike Hill (Hartlepool) (Lab)
On the issue of the effects on mental health, a number of concerned constituents have now come to see me about visits to care homes and to relatives in supported living accommodation. Does my hon. Friend agree that there appears to be a one-size-fits-all approach to visiting, and that that needs to be looked at in the light of the experience in places such as Blackburn with Darwen, and Bradford?
Dr Allin-Khan
I thank my hon. Friend for his heartfelt and articulate intervention. He expressed the feelings of many families who feel ripped apart, unable to see those they love the most. A one-size-fits-all approach is not fitting at a time like this. We have to take into consideration the deep pain that families are going through.
We have been promised a “world-beating” test and trace system for months. Yet here we are, six months on, and our entire testing system is in a dire state. Members may be tired of hearing us talk about the state of the test and trace system, but we must be honest about the position we are in. Without a successful, adequate test and trace system, we risk losing lives and further affecting people’s mental health and businesses.
It has never been acceptable that there should be reports of people being asked to drive more than 50 miles to be tested. However, at this stage it is unbelievable. If people are being told to return to work or to go to school, but are prohibited from stopping in the street to chat with their neighbours, the least that should be expected of Government is to guarantee access to tests to those who need them. The Government knew that encouraging people to return to workplaces and opening schools would undoubtedly lead to a rise in demand for testing. Yet they have been nowhere near equipped to deal with it.
At this point, I would like to ask whether new concerns have been raised since schools and universities have gone back. How are restrictions ever to be lifted if people cannot get access to testing? I would like to know from the Minister what actions the Government are taking to rectify that, and I would like assurances that areas in local lockdown are not facing prolonged restrictions owing to problems with the Government’s own test and trace system.
Adequate testing provision also relies on communication of what people need to do to self-isolate properly and for the correct amount of time. Nationally, there has been changing guidance on the incubation period of the virus, and the Government ignored World Health Organisation guidance in the early weeks. That led to mixed messaging and confusion about self-isolation guidance.
Locally, it would be helpful to have answers to the following questions. On “relevant persons” being responsible for the dispersal of gatherings, have any of the local authorities within the scope of the SI raised concerns about licensed premises and the inability to carry out checks due to not having enough resources to do so safely? How many fixed penalty notices have been issued for not adhering to the regulations, and how many offences were carried out under the regulations?
The decision to lift restrictions in certain wards, but to keep them in neighbouring ones, seems counter- productive. If infection rates are dangerously high on one end of the road, surely there is a risk of further spread of the virus. If they are not dangerously high, why does one end of the road have restrictions while the other does not? Can the Minister please explain the reasoning behind that? Again, have Ministers made these decisions in full partnership with the local communities that they affect, or have they overruled local leaders who raised concerns?
As I have already mentioned but feel it is necessary to reiterate, imposing restrictions without engagement with local authorities is absolutely the wrong way to go and will lead to confusion, frustration and an inevitable resurgence of cases. Only by working together can we curb the spread of the virus. I hope the Government listen to our concerns, and I look forward to hearing the Minister’s response.
Oral Answers to Questions
Rosena Allin-Khan Excerpts(4 years, 2 months ago)
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Helen Whately
As I expect the hon. Gentleman knows, we have announced £3 billion of additional NHS funding for the winter and are continually looking at additional funding needs for social care.
Dr Rosena Allin-Khan (Tooting) (Lab)
There is a looming mental health crisis this winter, and as such it is vital to meet with experts. I know the Secretary of State believes that that is important, so I asked him several parliamentary questions wanting to know how many mental health trusts and organisations he had met during the first three months of lockdown. I was told that he “holds these meetings regularly”, but a freedom of information request revealed that he and the Mental Health Minister organised only two meetings with mental health trusts and organisations during that entire period. Can the Secretary of State confirm that he did not attend either of those two meetings? Does he think that is an acceptable track record?
Helen Whately
The Secretary of State has regular meetings with stakeholders about the future of mental health.