Mental Health Units (Use of Force) Bill

Rosie Winterton Excerpts

Report stage: House of Commons
Friday 15th June 2018 Commons Chamber

[Sir Christopher Chope]

The Government’s line seems to be that this legislation is an urgent measure. If it is so urgent, may I ask the Minister—through you, Madam Deputy Speaker—what state the guidance has reached?

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. The hon. Gentleman is making an intervention on the hon. Member for Shipley (Philip Davies), not the Minister.

[Sir Christopher Chope]

I invite my hon. Friend the Member for Shipley (Philip Davies) to ask the Minister whether she agrees that, because of the urgency of this legislation, the guidance is ready in draft form in her office and can be laid before the House tomorrow or in the next couple of weeks. I suspect that the Government have not even begun to draft the guidance, but we need the guidance before this legislation would ever be able to take effect.

NHS Outsourcing and Privatisation

Rosie Winterton Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. As colleagues will see, a vast number of Members want to speak in the debate. I will impose a four-minute limit after we have heard from the spokesman for the Scottish National party.

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[Madam Deputy Speaker (Dame Rosie Winterton)]

Order.

Education (Student Support)

Rosie Winterton Excerpts

Wednesday 9th May 2018 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

I must inform the House that the Speaker has certified the instrument as relating exclusively to England and being within devolved legislative competence. The motion is therefore subject to double majority voting of the whole House and those representing constituencies in England.

Social Care

Rosie Winterton Excerpts

Wednesday 25th April 2018 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. Before I call the Scottish National party spokesperson, I should inform colleagues that we have about 17 people who wish to participate in this debate. I do not want to impose a time limit, which means that I require some discipline. I suggest that if hon. and right hon. Members confine their speeches to about seven minutes, we might not have to impose a time limit.

NHS Winter Crisis

Rosie Winterton Excerpts

Wednesday 10th January 2018 Commons Chamber

[Paula Sherriff (Dewsbury) (Lab)]

Here we are again discussing the latest winter crisis in our NHS. I stood here last year and spoke of the horror stories I had heard from my constituents and ex-colleagues of hospital staff working their fingers to the bone and doing the jobs of two, three or even four people, often without food, breaks or even time to go to the toilet. Yet, 12 months on, here we are again with many of the same challenges and none of the fixes promised by this Government.

I join my parliamentary colleagues in expressing a huge thank you to each and every one of our hard-working NHS staff—doctors, nurses, receptionists, cleaners, porters, radiographers and everyone else. I often speak of our public sector heroes, and today is no different. Thank you from the bottom of my heart.

I express a special thank you to the paramedics who rushed my father, my dear dad, into hospital on 28 December. My gratitude is infinite.

Last year, the Government said the winter pressure was due to more patients being seen by the NHS. That figure is rising year on year, so why have the Government not put sufficient resources in place to deal with it? The Health Secretary previously said there are far more doctors and nurses in our NHS than there were seven years ago. In my area, the Mid Yorkshire Hospitals NHS Trust currently has 230 nursing vacancies, compared with 110 last year, with nursing numbers across the trust down over the same period from 1,752 to 1,607. That picture is somewhat different from the one painted by the Secretary of State, who has used figures that the Library says should be “used with caution” as suggesting

“Changes in the number of staff can sometimes reflect organisational changes and changes in the structure of services, rather than genuine changes in staffing levels.”

Indeed, staffing levels are so low at Mid Yorkshire Hospitals NHS Trust that the Care Quality Commission has deemed it to be a risk to patient safety.

My colleagues and I were heavily criticised during last year’s debate for asking the Government to spend more money, and once again we hear the same criticism this year. Will they tell us what the solution actually is? We need more nurses, and obviously there are training implications, but more money is needed to pay for them, and it is the same with doctors. There needs to be less bed-blocking, and more money is needed in social care. It is only right that serious questions are asked in this House when the Budget gives more money to pay for Brexit than to pay for our NHS.

The sad reality is that NHS deficits are rising astronomically across the country, with multimillion-pound shortfalls being recorded and balancing the books becoming impossible for most trusts. The £350 million made available in the Budget is no more than a drop in the ocean, and it has been proved over and again over the past few weeks that the money does not even scratch the surface.

And what of the cost of cancelled operations, both to trusts and especially to patients? People are being left in tremendous pain and at significant risk as a result of cancellations. I know of one man who is waiting for an operation to close his skull following life-saving brain surgery earlier this year. The surgery itself is not classed as urgent, but until it is completed, he is at increased risk of death should he bang his head accidentally. As a result, he rarely leaves the house and has to wear a helmet at all times. Another person who contacted me is waiting for a new knee. He is in excruciating pain and is unable to move around unaided. He has been on sick leave for three months and is suffering severe financial hardship as a result of loss of earnings.

As well as the accounts of cancelled operations, in recent days I have heard stories from local hospitals of six patients being squeezed into four-bed bays with no curtains and no dignity, no lockers and no bells. Patients are being given hand bells or are told to ask the patient next to them to ring the bell should there be an emergency. Patients are being placed in store cupboards, as we heard earlier. It has now become almost the norm at this time of year—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order.

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[Damien Moore (Southport) (Con)]

I am really pleased to be able to contribute to the debate. Although the Opposition have, as expected, used this occasion yet again to weaponise our NHS, I want to take this opportunity to praise it and all those who work in it, particularly in my constituency, where the staff at Southport Hospital are professional, dedicated and hard working.

There will always be times when our NHS comes under great pressures, and winter is one of them. That was why, in 2017, the Government and the NHS began preparing for the winter earlier than ever before. Last autumn, the Secretary of State visited my local hospital. He had a meeting with me and the interim chief executive in which we talked through the plans that had been put in place for the coming winter, as well as paying tribute to excellent staff who had worked so hard and continue to do so. Those preparations involved working with a range of partner organisations, including the local clinical commissioning group, the local authority and the emergency services, which provided better joined-up thinking and better care for patients.

Although the deferment of elective operations is never ideal, fewer were deferred this winter than in previous years, which should surely be welcomed. I am certain that the situation will further improve over the coming years. It is important to remember that we have a record of continuous investment in the NHS, even though we have been faced with extraordinarily difficult economic circumstances. The Department of Health’s budget has been protected since 2010 and continues to rise. We can spend more on the NHS only when we have a strong economy, which is something that we clearly would not have under Labour. The numbers speak for themselves: our investment in the NHS will rise from £101 billion in 2015 to £120 billion by 2020. Research from the Nuffield Trust shows that the UK spends well above the EU average.

I must welcome the Government’s multimillion-pound investment in Southport District Hospital over this winter. I was delighted when Southport and Ormskirk Hospital NHS Trust was granted an additional £1.326 million in funding to help to cope with winter pressures. Southport Hospital and the wider health system has prepared earlier and more extensively than ever before for winter this year, with a focus on securing the right numbers of doctors and nurses and increasing bed availability, as well as making sure that there is strong social and community care support available to help to discharge patients from hospital quickly.

The extra funding was announced as part of a £337 million immediate funding boost for NHS hospitals this winter in the recent Budget, which is in addition to the extra £2.8 billion of investment over the next two years. This was, of course, welcome news for Southport patients and residents. We all want to know that the NHS is there for us and our families whenever we need it. I am pleased that the Government have given the NHS extra support at this critical time of year, when cold weather and flu can increase pressures on hard-working hospital staff.

One of my constituents recently contacted me to tell me about the excellent treatment that his elderly mother had received at Southport Hospital over the Christmas period, after she suffered a serious health scare. His mother and his family were unanimous in their praise for the paramedics who brought her to hospital, the nurses who treated her with unparalleled kindness, and the doctors who sought to get her back to full health as soon as they possibly could. His mother said of her treatment that

“we couldn’t have asked for more.”

It is my absolute pleasure to put on record their sincere thanks to my right hon. Friend the Secretary of State, whose brief now includes social care. I am sure that he will make a success of that job as he has done in health.

It is ultimately thanks to our strong economy that we can make this extra investment in the NHS. Polls show that the NHS is the institution that makes us most proud—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order.

Social Care

Rosie Winterton Excerpts

Wednesday 25th October 2017 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. Before I call the hon. Member for Central Ayrshire (Dr Whitford), who is speaking for the SNP, let me say that we have a lot of speakers this afternoon, so after her speech I will bring in a time limit. The time limit will be five minutes to start with, but it may have to be reduced later.

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[Gill Furniss (Sheffield, Brightside and Hillsborough) (Lab)]

Nearly every day, my office is introduced to a new case in which a constituent and his or her family are facing the harsh and difficult realities of a social care system in crisis, but this is not a crisis born out of necessity. Unfortunately, it is the cruel consequence of an ideologically driven cost-cutting agenda in action. It is a crisis that has been created at the heart of No 10.

The Tories have presided over an unprecedented attack on social care budgets. Some £4.6 billion has been taken from adult social care budgets since 2010, at a time when demand is growing. Reports by the King’s Fund make it clear that the adult social care system as it stands is

“failing older people, their families and carers”,

and that it will have a funding hole of £2.1 billion by 2019-20 which, if left unresolved, will continue to fuel the crisis. The same pattern is found in my home town, Sheffield, where there is a growing population of over-65s, all with a longer life expectancy than ever before. Sheffield City Council’s budget has been cut to the tune of £352 million since 2010, and further cuts are on their way.

As a result of the cuts, councils have had to make difficult decisions. Across England, 400,000 fewer people are able to access publicly funded social care, and one in eight older people is living with unmet care needs. The impact on people and their families in our communities has been harrowing. What is more, the deep cuts inflicted by No. 10 are not only cruel, but nonsensical and ineffective. For example, councils are having to limit the hourly care fees paid to providers.

A recent case in my constituency has highlighted the doubly negative effect of limited administration and care payment resources. My constituent has significant daily care needs, and she and the council have struggled to keep up with resourcing those complex needs. Care providers have withdrawn at short notice, leaving the council and the patient’s family frantically trying to find a new provider. The under-resourcing of social care creates the dual problem of a higher than acceptable turnover of providers, and councils without the resources to step in effectively. That causes much upset and pain to the most vulnerable in our society.

Another consequence of the deep cuts is the level of the duty of care that is being placed on unpaid carers, and, as we know, women are largely bearing the brunt of that work. In one case, a granddaughter cared for her grandmother for 100 hours per week, and when she applied for a care package in the hope of receiving some financial support, it took six months to come through. The long-winded process often leaves carers with no support at all. That is not an isolated case; in fact, there are 6.5 million unpaid carers in the UK.

I am proud that in Labour’s election manifesto we pledged to increase carer’s allowance for unpaid full-time carers to align the benefit with jobseeker’s allowance rates. That is a practical and sensible solution, which also seeks to highlight the valuable work that nurses, social care workers and carers do for our communities. Too often, they are sidelined and their efforts shunned. They need a Government for the many, not just the privileged few, to stand up for them.

Crucially, the knock-on effects of a social care crisis are felt acutely by the NHS. Indeed, this year’s general election was the ultimate litmus test for the social care policies presented by the Tories and the Labour party. Labour not only pledged to invest £8 billion to alleviate some of the immediate problems facing social care, but promised to build a new national care service bringing together health and social care, which we would implement following a cross-party consensus. In a civilised society, it is vital for us to pool the risk, and not allow the most vulnerable to fend for themselves in old age.

Meanwhile, the Prime Minister launched a nasty campaign against older people the likes of which we have not seen in decades. Following their U-turn on the dementia tax, the Tories have now turned their attention to blaming and threatening councils with fines and sanctions—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I am afraid that I am going to have to cut the time limit on Back-Bench speeches to three minutes as a lot of speakers are still waiting to get in.

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[Mike Amesbury (Weaver Vale) (Lab)]

The benchmark of a civil society is how it treats its elderly, its vulnerable and those who need support the most. Those are the values that underpin the outstanding work that happens every day in my constituency, Weaver Vale, and in constituencies across the country.

Whether care workers, nurses, social workers or volunteers who look after their neighbours, these people are motivated by a simple principle. As a country, we should care for, and care about, everyone in our society. Sadly, the reason we are having this debate today is that, when it comes to sharing and showing support for those values, this Government have let down the very people who deliver them and have failed those who rely on them.

Year after year, as they delivered their cuts, the Government who claimed that we were “all in it together”—remember that one—took aim at the most vulnerable instead of protecting them. Councils in my constituency have seen their budgets cut by 43%, with the most vulnerable struggling to access the care they need. Like many former councillors in this Chamber, I saw at first hand what cuts did to services and the effect on the people who relied on them. Now, as an MP, I witness this all too often. That effect was ignored by this Government again and again, until the Prime Minister was finally forced to listen. Even then, the action offered failed to deliver what was needed, putting the burden once again on local councils and residents, rather than on Downing Street, the only place that can deliver the proper funding needed to rectify this crisis.

The good news is that with proper, decent funding we can make a difference, by providing our amazing social care staff with the support they so desperately need. That is why we need a Labour Government. Earlier this month, I met the integrated care team in Cheshire West and Chester. Based at a local medical centre, they bring together district nurses, care workers, social workers, occupational therapists and co-ordination staff, providing excellent integrated care. The innovation and dedication of the team is exemplary, but unfortunately the funding is not. The workload exceeds staffing resources. The team needs six district nurses, but it typically operates with three or four. Recruitment is a struggle, and there is a shortage of carers in the area. Patients can be ready to leave hospital but no care packages are in place because of the lack of funding. This is the consequence of years of cuts and of pay freezes, zero-hours contracts—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order.

Valproate and Foetal Anticonvulsant Syndrome

Rosie Winterton Excerpts

Thursday 19th October 2017 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. If colleagues could stick to around nine minutes, we will be able to get everybody in.

Contaminated Blood

Rosie Winterton Excerpts

Tuesday 11th July 2017 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. May I remind hon. Members that Mr Speaker asked that speeches be kept to about five minutes?

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[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I do not want to impose a formal time limit, but I would ask Members to try to keep to four minutes. I will not then have to impose a formal time limit.

Oral Answers to Questions

Rosie Winterton Excerpts

Tuesday 7th February 2017 Commons Chamber

[Mr Hunt]

I am pleased that my hon. Friend raises that point, because when we discuss mental health we often talk about services provided by mental health trusts but do not give enough credit to the work done in primary care, both in community hospitals and by general practitioners, who have a very important role as a first point of contact. He is absolutely right to make that point.

[Dame Rosie Winterton (Doncaster Central) (Lab)]

Will the Green Paper look at the role that educational psychologists could play not only in providing support and assistance to young people with mental health problems but in preventive work? Cuts in local authority budgets have meant that the service has become quite fragmented, but there are practical ways in which it could be improved to help young people with mental health problems.

[Mr Hunt]

The right hon. Lady is absolutely right. We have looked into this and realised that there are two issues when it comes to improving children’s and young people’s mental health. The first is improving access to specialist care for those who need it. The other is prevention: the work that can be done by teachers within schools and in training people in mental health first aid. Those kinds of things can make a huge difference and we want to make sure we do them both.

NHS and Social Care Funding

Rosie Winterton Excerpts

Wednesday 11th January 2017 Commons Chamber

[Dame Rosie Winterton (Doncaster Central) (Lab)]

The debate so far has shown the huge level of concern from the public and NHS staff about the crisis in the NHS and social care. The hon. Member for Totnes (Dr Wollaston) reflected some of the views of the Select Committee, but I ask all Government Members to take those concerns seriously and not to dismiss them. All hon. Members must surely be receiving representations from staff and patients about what is happening locally.

I want to pay tribute to all the health and social care staff in Doncaster, in particular those at Doncaster royal infirmary whose work I have seen at first hand. I know how dedicated and committed they are to caring for patients in these most difficult of circumstances. At the end of December, they had managed to achieve 90% against the 95% target and had good ambulance handover times, as well as good support from the council and community partners, but they are facing real pressures and they are fearful about the pressures still to come, especially if, as predicted, there is a cold spell. That is why the mixed messages from the Secretary of State have been extremely damaging.

I was a Health Minister for four years and had responsibility for emergency care. I know how important it is to work with NHS staff to help to implement targets, and not to give the impression that the NHS is somehow giving up on those targets. The lead from the top is incredibly important. There has always been controversy about targets, but as a Health Minister I visited many, many A&E departments. There is absolutely no doubt in my mind that the A&E target led to improved care for patients and that it reduced waiting times dramatically. The evidence is clear: it shows that that is what happened. One striking thing about those visits was seeing how consultants, nurses, ambulance teams and all members of the healthcare team worked together. For example, they would work out protocols so that emergency nurse practitioners could take over some of the work previously done by consultants, to ease the burden and share the work among the team. Triaging—seeing who needed urgent treatment by a consultant and who could be seen by a nurse practitioner—became the norm.

I would ask staff, “Is the target getting in the way, or is it helping?”, and invariably the answer would come back, “It helps us to work together more effectively.” I vividly remember a nurse practitioner saying, “Please don’t abandon the target, because it is making the consultants sit down with us and look at the whole team.” For patients, the difference was crucial, as it was for practitioners’ working lives, because they were not having to see patients who had been sitting around for hours and were feeling thoroughly depressed and demoralised. That made a difference to the healthcare team as well, because it improved their working life as well as patient care.

[Dr Murrison]

Does the right hon. Lady agree that it is not so much meeting the target that is important as getting patients seen expeditiously and well? There is not an A&E department in this country that does not want to improve its position in the league table of response times. The difference that now applies, and which perhaps did not apply quite so much when she was a Minister, is that the level of informatics and comparison is much improved. I suggest to her, ever so gently, that while the four-hour target was important when she was a Minister, its importance has degraded over time, because everybody is trying to see patients more quickly.

[Dame Rosie Winterton]

I do not agree with the hon. Gentleman. The four-hour target led to much better diagnoses and much improved provision of the type of treatment that people needed, as well as better interaction with communities. And I want to come on to that point because the Secretary of State has been trying—perhaps the hon. Gentleman is guilty of this as well—to separate the target for A&E departments from what happens outside, whereas I see the importance of putting the two together. Providing alternative treatment, which is perhaps part of what the hon. Gentleman was getting at, means having proper support in the community. It was bringing those two things together that made it possible to achieve the target, so it was a driver.

[Maria Caulfield]

Will the right hon. Lady give way?

[Dame Rosie Winterton]

I give way to the hon. Lady, who I know has some experience of this.

[Maria Caulfield]

In my experience of trying to meet the four-hour target, it is often—or was in the past—prioritised over everything else, including patient care and clinical need. It was sometimes abused, with huge pressure put on staff to meet the target, and as a result patient care suffered. I saw that myself.

[Dame Rosie Winterton]

It is always important to look at the feedback from clinicians, and I did that as a Health Minister. It started during my time as a Minister, and I remember that we had constantly to consider whether there was a clinical reason for reducing the 95% target. It became clear that some patients needed longer to be assessed owing to their particular condition. In such cases, I could see why the target might need to be reduced, but that was based on clinical need. By contrast, the impression given last week was, “My goodness! We’re going to have to cope with some winter pressures. Let’s reduce the target in order to meet it,” rather than there being an assessment of clinical need. That sent completely the wrong message to the NHS. I think it was the wrong thing to do.

I want briefly to set out some areas in which we can bring the community input together with what is happening in emergency departments to reduce some of the pressures. The first point was that made by my hon. Friend the Member for Leicester South (Jonathan Ashworth), who spoke from the Front Bench. Good social care is vital to ensuring that people do not end up in A&E. I have previously raised problems with the Government’s current proposition to, in a sense, move responsibility for raising money to local councils. That is particularly unfair in areas such as mine, which simply cannot raise the same amount of money through a council precept as better-off areas can. It simply does not work. We need it probably more than any other area, but we will be less able to raise the money.

On shortages, I have been talking to senior NHS staff in Doncaster, and there are real problems with emergency care staffing. They tell me that although more doctors are being trained—I accept that—it will take years for them to come through. The single most effective step we can take to ease pressure on A&E departments is immediately to increase funding for social care, because it would keep people out of A&E departments, and it could be done straightaway. The personnel are out there; the Government just need to increase the funding, as my hon. Friend said from the Front Bench.

We also have to look seriously at the problem of GP shortages. As others have said, if patients are waiting three weeks to get an appointment with a GP, they are bound to end up in A&E. This needs to be addressed very quickly, with proper forward looks at exactly where the gaps are in GP services. I have said before that PCTs—now clinical commissioning groups—or NHS England should be able to take over practices and employ salaried GPs. That would make a huge difference.

Furthermore, on community pharmacies, if people are confident that going to a pharmacy will save them a visit to A&E, again that will relieve pressure on the system. I hope, therefore, that the Minister will assure us that he is looking seriously at the community pharmacy forward view, which sets out how pharmacies can be integrated into the NHS and social care.

Briefly on mental health, the Prime Minister answered a question today about mental health and the crises that people can get into, which mean that they end up in A&E. She talked, in particular, about young people. I urge the Minister to consider the role that educational psychologists can play in children’s mental health and in keeping them out of A&E.

It was my experience as a Health Minister that we needed people on the ground locally to help organisations across the spectrum—local government through to social care, pharmacies, GPs and ambulances—to work with A&E departments, yet the £2 billion reorganisation that removed PCTs and strategic health authorities has made it much more difficult to drive through the necessary changes. I hope, therefore, that the Minister will look very seriously at what has happened, because local knowledge can be vital.

On the basis of the Secretary of State’s contributions, it seemed that he was trying to use every excuse not to face up to the reality of what is happening. I think that sends a terrible message to NHS staff. I hope that, as a result of today’s debate, the concerns raised will be taken on board by Ministers and the Secretary of State and that they will come back to us with a proper plan that recognises the problems and offers real solutions.

[Several hon. Members rose—]