Cass Review

Rosie Duffield Excerpts

Monday 15th April 2024 Commons Chamber

[Madam Deputy Speaker]

Order. I am anxious to ensure that everyone gets in, because this is an important statement, but we also need to ensure that the questions are brief so that the Secretary of State can give brief responses. We have a big debate ahead of us on the Safety of Rwanda (Asylum and Immigration) Bill, followed by another debate on the hospice movement, and I am sure that many Members will want to participate in those as well. Perhaps they will bear that in mind when framing their questions.

[Rosie Duffield (Canterbury) (Lab)]

Let me first thank the Secretary of State for her thoughtful and considered statement on the Cass review, and especially for mentioning the journalists, such as my friend Hannah Barnes, who blew the whistle on the Tavistock clinic. As she has said, those who have raised this issue over the last few years, desperately concerned about the safeguarding of vulnerable children and young people—too young to make life-changing decisions—are owed a heartfelt apology for being no-platformed, ghosted, sidelined and disciplined at the behest of a few extreme groups of activists, some within political parties. Does she agree that these academics, politicians, writers, psychologists and actors, along with any other people who have questioned the signing up of their workplaces to Stonewall law, have now been vindicated by Dr Cass’s expert review, and that they should be apologised to?

[Victoria Atkins]

I come to the Dispatch Box with huge admiration for the hon. Lady for the commitment that she and other Labour Back Benchers have shown, in a culture and an atmosphere in which their views were demeaned and they were sneered at and castigated. Indeed, I hear rumours that efforts were made to remove certain Members from the party itself. This is the moment for apologies and for humility, but also for us to start a clean page and ensure that, when perfectly reasonable questions are asked about the medical treatment of our children, those questions are allowed to be asked in an atmosphere of respect and understanding, so that these vulnerable children and young people are looked after in a caring and careful way.

Sexual Harassment of Surgeons and Other Medical Professionals

Rosie Duffield Excerpts

Wednesday 13th December 2023 Westminster Hall

[David Mundell (in the Chair)]

I will call Rosie Duffield to move the motion. I will then call the Minister to respond. There will be no opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

[Rosie Duffield (Canterbury) (Lab)]

I beg to move,

That this House has considered the matter of sexual harassment of surgeons and other medical professionals.

It is a pleasure to serve under your chairship, Mr Mundell. I am grateful for the opportunity to raise the issue of sexual assault against surgeons, nurses, doctors and other healthcare professionals and patients in clinical settings. In April, I used my Prime Minister’s question to mention the report commissioned by the Women’s Rights Network and written by my friend, the sociologist and criminologist Professor Jo Phoenix, entitled “When we are at our most vulnerable”. The report revealed some truly shocking statistics about violent sexual assault, and everyday inappropriate and unwanted acts intruding into the work lives of professionals and disrupting the recovery of the most vulnerable and ill. How dare we call ourselves a civilised society if we turn a blind eye to this and do not do everything possible to support those women, and some men, who are brave enough to come forward, as well as those who do not feel that they can and suffer in silence?

Professor Phoenix found that more than 6,500 rapes and sexual assaults had been committed in hospitals in England and Wales over a period of nearly four years. Some were against children under 13, yet in a mere 265 cases—a minute 4.1%—was anyone known to have been charged. In total, 2,088 rapes and 4,451 sexual assaults—6,539 cases—were recorded by police forces from January 2019, and one in seven of those, or 266 a year, took place on hospital wards. As the researchers at the Women’s Rights Network sent freedom of information requests to 43 police forces across the UK and 35 responded, the figures are, in truth, even higher and even more shocking.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on securing this debate and on what she does. Those of us who are here have a particular interest. A recent survey of 2,500 doctors by the British Medical Association found that 33% of female and 25% of male respondents had experienced unwanted physical contact in the workplace. Worse still, these are only the figures for those medical staff who felt confident enough to come forward, so unfortunately the figure is probably much larger. Does she agree that provision must be put in place in the NHS and other, private healthcare facilities to ensure that staff members feel not only safe and protected, but encouraged to come forward and discuss instances of sexual abuse and rape within the workplace? In other words, there must be somewhere to go, someone to talk to and someone to sort it out.

[Rosie Duffield]

Absolutely, and I thank the hon. Member so much for raising that important point, which is supported by all the work that the BMA has done, including the report that he mentioned.

The rape of a female child under 13 was included in those shocking statistics, alongside the rape of a female over 16 by multiple offenders in west midlands hospitals, three rapes of a female under 16 in Cambridgeshire, and six rapes of girls under 13 in Lancashire. It is important to note that although the FOI responses do not record the sex of the victims, national data shows that less than 5% of rape victims are men, so it is reasonable to assume that most victims are female. The investigation uncovered 13 rapes of males over the age of 16, however, including one incident involving multiple offenders, and the sexual assault of a male child under the age of 13 in a Cambridgeshire hospital.

We know that hospitals are, of course, monitored by many CCTV cameras, and individual wards usually have safe-door entry systems, which prompts the question of why only a tiny percentage of cases—4.1%—resulted in a charge or a summons. Indeed, five police forces did not issue a single summons or charge a single suspect for any of the 334 reported sexual assaults in their areas. Why not? The WRN report says:

“The damning figures are probably ‘the tip of an iceberg of indifference’ around the safety of NHS patients and staff”,

as some forces gave inadequate information. For example, Police Scotland did not provide any figures, citing cost constraints, and of those forces in England and Wales that did respond, seven forces provided incomplete responses, five did not give information on the number of assaults that occurred on hospital wards, and three did not provide information about the number of people charged or summonsed.

As Heather Binning, founder of the Women’s Rights Network, says:

“These statistics are jaw-dropping. We began this investigation because a number of members raised concerns about the safety of women and children on NHS wards, but we are horrified at what we have uncovered.”

I am grateful to the WRN for highlighting this problem and shining a light on something that has gone almost completely unnoticed in this place before.

The BMA represents doctors and medical students across the UK. It also produced a briefing for today’s debate, as we heard earlier from the hon. Member for Strangford (Jim Shannon). It states:

“The BMA is deeply concerned by the overwhelming number of doctors who have experienced sexual harassment at work.”

Its “Sexism in medicine” report of September 2021 found that 91% of women doctors in the UK have experienced sexism at work, with 42% feeling that they could not report it.

[Caroline Nokes (Romsey and Southampton North) (Con)]

The hon. Lady is highlighting a very important issue. She made a point about reporting, which is certainly an enormous challenge. The Women and Equalities Committee heard from Chelcie Jewitt of Surviving in Scrubs, who made the point that when doctors tried to report harassment, they were often told by the General Medical Council that it was a trust issue, yet the trust would say that it was a GMC issue. Does the hon. Lady think that goes some way to explaining why there is a lack of reporting and that, when there is reporting, it seems nothing gets done?

--- Later in debate ---

[Rosie Duffield]

Absolutely. I thank the right hon. Lady so much for raising the work that Surviving in Scrubs does. I know that its evidence was really important for her inquiry.

The survey found that doctors’ experience of sexism and sexual harassment had prevented them from choosing certain specialities and had affected their career progression. Doctors say that the very structure of medical training creates a power dynamic, where perpetrators can have a significant impact on doctors’ opportunities to progress. The scale and severity of sexual harassment in medicine was further highlighted by the working party on sexual misconduct in surgery survey, which found that a third—a third—of NHS female surgical staff had been sexually assaulted by colleagues in the past five years.

These shocking findings led the BMA to launch its “Ending Sexism in Medicine” pledge in March 2023, which over 60 organisations have signed. The pledge aims to help ensure

“a world where doctors and medical students can work in a safe environment free from discrimination, and where gender plays no role in career progression or how they are treated.”

The pledge commits to ending sexual harassment in medicine and ensuring that structures are in place to enable reporting safely.

The BMA has called for the Government to implement legislation that includes a preventative duty on employers to take all reasonable steps to prevent sexual harassment taking place, including from third parties, and to support the Worker Protection (Amendment of Equality Act 2010) Act 2023, which places an obligation on employers to protect employees from sexual harassment. It stresses that all vital protections, policies at work, legislation and support for staff members must also be applied to students undergoing vocational training rather than just those classed as employees. As someone with a medical school in my constituency, I could not agree more.

I am also grateful to Tamzin Cuming, chair of the Women in Surgery forum at the Royal College of Surgeons, and to Professor Carrie Newlands, co-lead of the working party on sexual misconduct in surgery, for their report “Breaking the Silence”. The foreword is written by Professor Dame Jane Dacre, who says:

“This report shows that we still have a long way to go in demonstrating the respect that our female colleagues deserve in the surgical workplace. The survey findings of sexual misconduct are eye-watering and upsetting. It is difficult to read some of the testimonies, and this work should galvanise all healthcare organisations to make sure the problem of sexual misconduct is eliminated.”

It is an outstanding report that includes shocking data and statistics as well as chilling quotes from those affected. I urge anyone here to read it.

I cannot do justice to this work in such a short debate, but I want to read some of the quotes from those who took part:

“I watched a consultant fiddle with the hair of an industry representative, and kiss the back of her neck, at work. She was in a difficult position and did not want to report the incident.”

Another says:

“He’d frequently rub himself against me repetitively during surgery, grunt and gasp in my ear, then leave the operating theatre before the operation was over. The scrub nurse used to help me close up. She once cried with me after surgery and reminded me that she was powerless to do anything, but that she cared.”

Another states:

“The orthopaedic consultant, during an operation, discussed with his (male) trainee how they like blow jobs. It was my first day in theatre.”

I apologise for the unparliamentary language.

Those accounts are just a small snapshot of some of the report’s findings. It represents a lot of work and I hope that the authors’ recommendations can be given serious consideration by health bodies and the Government, along with the important work of the GMC, which has produced updated guidance on good medical practice and professional standards, which I am afraid I have not had time to give justice to today.

Since entering Parliament, I have focused on women’s health, our experiences of the NHS and maternity healthcare services. The pressures and enormous stress placed on our NHS professionals are well known, but these women who save lives, whether as a surgeon, nurse or a friendly reassuring receptionist, deserve to work in a safe and respectful environment, where they are given the dignity they deserve. Patients must feel and be safe at all times within a clinical setting. I am certain the Minister agrees, and I would be happy to work with him to ensure we get a much better place for all of those who need and love our NHS.

East Kent Maternity Services: Independent Investigation

Rosie Duffield Excerpts

Thursday 20th October 2022 Commons Chamber

[Dr Johnson]

I thank my right hon. Friend for his comments. I note that he has been a doughty campaigner on this issue, and I know how much it matters to him personally, as well as as a Member of Parliament. I would of course be happy to come to Margate to meet the staff he describes.

[Rosie Duffield (Canterbury) (Lab)]

I thank the Minister for her statement, Dr Kirkup and his team, and the families and staff who took part in the inquiry. It is clear that there has been an utterly toxic and dysfunctional culture within maternity services at the East Kent hospitals trust. It is shocking and disturbing, and made so much worse by the revelation that the trust tried to cover up these cases. Mothers were treated appallingly and babies died. I cannot comprehend what they have had to endure, and I am so angry on their behalf. How can the Minister assure my constituents that action leading to immediate change will not involve any of the staff and managers involved directly in these cases? And given that former staff and a governor have said publicly that they cannot recommend the service, how can MPs in East Kent tell our constituents that our maternity services are now safe?

[Dr Johnson]

I know that this is a matter on which the hon. Lady has been campaigning furiously on behalf of her constituents. I share her anger, and her shock when I read the report, at some of the cases and some of the ways in which patients have been spoken to during their time at their hospital. It is truly unforgivable.

On the question of safety, that was my first question when I read the report: are we sure that patients going in today to have their babies are safe to do so? So I met Anne Eden, the regional director of NHSE, yesterday to talk to her about safety, and I have been reassured about both quality and outcomes. On outcomes, I have been reassured that, looking at crude data, which I appreciate has not been published yet, the numbers of stillbirths and neonatal deaths over the last year or so have fallen substantially. On quality, it is doing a review, so each woman is contacted six weeks after her delivery to ask about her experiences, and where experiences have not been as they should be—although they are in almost all cases—that has been further investigated in each case.

Children’s Mental Health

Rosie Duffield Excerpts

Tuesday 8th February 2022 Commons Chamber

[Rosie Duffield (Canterbury) (Lab)]

Here on the Opposition Benches we often refer to a crisis—the cost of living crisis, the fuel crisis and the poverty crisis—but the dire lack of children’s mental health services is exactly that. I need a stronger word to describe the absolute gaping void where even the most basic help, support and accessible services should be. As mentioned by my hon. Friend the Member for Bristol East (Kerry McCarthy), I learned last week of a constituent whose 13-year-old daughter was sent from Whitstable to Manchester. Surely there can be nothing on earth more stressful or soul-destroying than being unable to get urgent help for your child when they are suffering.

In debates such as this, our respective parties will send around statistics. The ones that we received today say that three quarters of children are not seen within four weeks of being referred to children’s mental health services. As bad as that sounds, the reality is so much worse. In the almost five years that I have been holding regular surgeries I have seen case after case where parents are beyond desperate. They arrive, often a mum and a grandma, sometimes with the child in tow, with that all-too-familiar huge black folder rammed full of copies of emails, statements or education and health care plan paperwork, and report after report that makes it blatantly obvious that urgent help is needed immediately. I see parents crying in my office or over Zoom every single week without fail. Their health is affected as well. The stress and anxiety that those parents experience is off the scale. In some cases the young person has missed school for months, had problems for years, is self-harming or feeling suicidal. Parents have to leave their work and become full-time carers and campaigners just to secure an appointment for an initial assessment.

The Labour party has announced today that we want all children to be seen within four weeks, but that would be a miracle for most of the children and families that contact my office. When we first started taking on those cases, we were frustrated and upset to meet people who had been waiting for, on average, around 18 months. It then grew to two years. A few weeks ago, I met a desperate mother who had been waiting for help for her child for four years.

This is a huge crisis. The nation’s children and young people are being failed. What can we do? Is simply signing a bigger cheque the solution? We need to look at the systemic problems and the solutions we can get from health professionals. We have some brilliant professionals in Canterbury, but they are desperate and they need help. Surely we need to look urgently at the structure and provision and the lack of uniformity across the UK.

We must restore preventive mental health services in schools, hubs and communities, with professionals available to offer proper support to the currently more than 100 complex long-term cases I have. Many other MPs are desperate for help as well. I do not want to see any more parents crying in my surgery. Please let us get them some support before it is too late.

Menopausal Symptoms: Support

Rosie Duffield Excerpts

Wednesday 9th June 2021 Westminster Hall

[Rosie Duffield (Canterbury) (Lab) [V]]

It is a pleasure to serve under your chairship for the first time, Ms Ghani. I thank my hon. Friend the Member for Swansea East (Carolyn Harris), the deputy leader of the Welsh Labour party, for securing the debate today and for all that she is doing to raise awareness of this and many other women’s health issues.

Menopause will affect the vast majority of women, with some experiencing menopause earlier as a result of cancer or other health conditions. I have friends who have gone through it who then have the added stress of having to explain to others why they are unable to have children, or to share their medical histories. There seems to be such a lack of awareness and understanding of issues around the menopause. It can still feel like a bit of a taboo subject.

The menopause is, of course, a women’s health issue, so quite why the House of Commons titled today’s debate

“support for people experiencing menopausal symptoms”

is a bit of a mystery, particularly when the House of Commons Library report uses the word “women” throughout. Like all mostly women’s health issues, there is often difficulty with our being able to access the right help or support, or even the most basic information. Like many women in Parliament, I am in the age group most likely to be experiencing menopause and, like most women I know of my age, we rely on personal and professional friendship groups for sharing information and our own experiences. We talk to each other and usually find that every one of us will have had some similar, but also some very different, symptoms. It is often hearsay, rumour, second-hand or third-hand stories, shared articles or scraps of advice that are our main source of information about this major life change and huge change to our bodies.

My constituent, Elizabeth Ellis, started her campaign group 50Sense and the campaign “Know Your Menopause” to inform women after she could not get any help and support when she was first going through the menopause herself. How many times do politicians meet people like Elizabeth, who have used their own life experiences to become an expert and a champion in order to help others?

50Sense’s Pausitivity campaign produces a variety of really useful information, as well as posters that people can print out and put up in their workplaces and ask GPs to display. I encourage anyone who wants to know more to find the pausivity.co.uk website and download the great resources, including questions to ask GPs. Of course, that includes men. As husbands, partners, friends, colleagues and responsible employers, they ought to find out as much as they can, too, about this big event in the life of almost every woman they know. I hope hon. Members will note that I left sons out of that list, as, if I am being honest, I know that mine really do not want me to discuss my menopause with them, as lovely as that might sound.

Elizabeth, my constituent, and so many other women like her, should not have had to go back and forth to the GP for almost four years, with symptoms that she now knows were quite obviously the menopause. She was sent to A&E with heart palpitations and was even asked more than once if she was a cocaine user. If she had seen one of the Pausitivity posters she has now produced, it would surely have saved her a huge amount of distress, not to mention the NHS a lot of money. Another constituent, Michelle, had a surgical menopause and, because of the horrendous symptoms and lack of NHS treatment, was forced to go to a private consultant and spend a lot of money because the support she needed was not there. These women are not alone. Menopause cafés such as those mentioned by the Under-Secretary of State for Transport, the hon. Member for Redditch (Rachel Maclean), in the last menopause debate are popular places for women to support each other and share stories. It is extremely common for many women to become almost suicidal with the lack of understanding or help available.

We need to end the postcode lottery or luck element of menopause support. All GP surgeries should have someone available to advise or support women, or should display a poster, so that they know what they are going through is perfectly normal. GPs and healthcare professionals can inform women about local support groups and menopause cafés. We need easy access to fully funded HRT treatment. Men too should also familiarise themselves with some of the facts. After all, most people in the UK are female and at some point will go through the menopause. I urge everyone to log onto pausitivity.co.uk or watch the excellent documentary produced by Davina McCall for Channel 4 recently.

[Ms Nusrat Ghani (in the Chair)]

To ensure that all the speakers get in, we must impose a time limit of four and a half minutes.

Coronavirus

Rosie Duffield Excerpts

Tuesday 15th September 2020 Commons Chamber

[Matt Hancock]

I understand my right hon. Friend’s point. We do understand the impact of the rules that we have to put in place. It is the same around the world: the rules that need to be put in place to deal with a pandemic are not pleasant ones or ones that anybody would want to have in force, but unfortunately they are necessary to save lives. Sadly, we are seeing the consequences, including in some of our closest neighbours, of what happens if we do not take the action that is needed.

[Rosie Duffield (Canterbury) (Lab)]

Although I am sure that many ordinary people were thrilled to learn that the Government’s rule of six does not apply to so-called sports such as grouse shooting, for which up to 29 people can mingle, expectant mothers in my constituency and throughout the country are unable to take their partners to crucial checks during pregnancy. Currently, individual health trusts are left to make decisions on this issue, leading to a postcode lottery. Is it not time that the Government stopped passing the buck, as they did to school leaders, and instead provided national leadership across the country on matters as vital as maternity care?

[Matt Hancock]

I have a huge amount of sympathy with the case that the hon. Lady makes. In fact, last week we changed the guidance on this issue to allow partners to go with pregnant women to these sorts of tests and, of course, to the whole of the birth. The Minister for Patient Safety, Mental Health and Suicide Prevention, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), is responsible for this issue and leading on it, and we have made some significant progress in the past week. I commend the campaigners who are pushing so hard to make sure that each hospital follows the new guidance so that people can have a loving partner with them during these very special moments.

Covid-19

Rosie Duffield Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

As the hon. Gentleman knows from my previous answers, that is not the way we are addressing this question. The way we are addressing it is that we will buy as many ventilators as are made. It is not a question of putting a target on it. We are just going after as many as we possibly can.

[Rosie Duffield (Canterbury) (Lab)]

Gaps in NHS capacity, particularly in mental health services, have been filled in recent years by excellent local charities in my constituency such as Home-Start, which supports isolated, disabled and terminally ill parents in their own home. However, it has now almost completely run out of money. How does the Secretary of State suggest that I support such charities to continue, now that we need their services more than ever?

[Matt Hancock]

To the extent that the charity, to which I pay tribute, can support the local effort, the hon. Lady’s local CCG will be best placed to make that judgment.

Maternity Services: East Kent

Rosie Duffield Excerpts

Thursday 13th February 2020 Commons Chamber

[Ms Dorries]

My right hon. Friend is absolutely right. One of the issues in dealing with the ongoing problem—this is a bit like the airline industry—is that we need to generate a culture in which NHS staff feel able to speak up without fear of blame or litigation and we can take learning forward. Another issue is that when we have inquiries, we should take the recommendations and ensure that they are implemented. That piece of work is also going forward, along with HSIB and inquiries. We should look at implementing absolutely everything that we can to make sure that the safest possible environment exists.

[Rosie Duffield (Canterbury) (Lab)]

I am extremely grateful to the Minister for addressing these urgent issues and to the right hon. Member for North Thanet (Sir Roger Gale) for securing the urgent question, as well as to the former Health Secretary, the right hon. Member for South West Surrey (Jeremy Hunt), who has shown a real interest in this case—especially now that he is Chair of the Health and Social Care Committee. I thank them very much.

I am grateful that we are talking about these inquiries and investigations. So many things have been brought up in the reports, and there are many questions from my constituents, dozens of whom are now really terrified about their future pregnancies and having babies in the area. Will the Minister think about committing to safe staffing levels, because there are so many issues in our trust, and that would be one way to reassure staff and patients?

[Ms Dorries]

I thank the hon. Lady for her commitment to working with her constituents, which is shared by my right hon. Friend the Member for North Thanet (Sir Roger Gale) and my hon. Friend the Member for Dover (Mrs Elphicke). I think that we should refrain from using words such as “terrified” because, as I said, the trust is a safe place for any woman to give birth. We have the best midwives, obstetricians and neonatologists from outstanding trusts working there now. She will know, as I do, that the trust’s location is slightly remote. Recruitment outside the major cities is a difficult issue, and we have to look at that for maternity services in trusts that are outlying in geographical terms. She is absolutely right to raise that issue, but I reiterate that it is very important that she lets her constituents know that the trust is a safe and welcoming place for women to go and give birth, because some of the very best staff in the country are working there right now and making sure that that is the case.

Oral Answers to Questions

Rosie Duffield Excerpts

Tuesday 28th January 2020 Commons Chamber

[Jo Churchill]

I am delighted to join my right hon. Friend in congratulating Jo’s Cervical Cancer Trust on the work it does. I had the pleasure of meeting its team only last week, who do fantastic work to raise awareness of vital cervical screening. He is right about Mike Richards’s review. We must ensure that we screen all the available population in order to see cervical cancer eliminated for good, which would be brilliant. I am delighted to support this year’s “Smear for smear” campaign. There is nothing shameful about human papillomavirus, and we must bust the myths, because being tested can save someone’s life.

[Rosie Duffield (Canterbury) (Lab)]

Following the desperately upsetting news headlines last week about preventable baby deaths at East Kent, including that of Harry Richford, aged just seven days old, whose death was described by the coroner as “wholly avoidable”, will the Secretary of State join me and Harry’s family in calling for a full, transparent public inquiry?

[The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)]

I thank the hon. Lady for raising this issue, and also my hon. Friend the Member for Dover (Mrs Elphicke), who made an excellent speech last night about this very issue at East Kent. I would like to reassure the hon. Lady that the Care Quality Commission conducted a further investigation of the whole trust last week and will take enforcement action if necessary. On Monday, I asked it to provide a summary report within 14 days. The Healthcare Safety Investigation Branch has examined 26 individual maternity cases at the trust, and it has already reported on 15. It was also asked on Monday to complete its work within 14 days and to send in a summary report to give us further information.