Southern Health NHS Foundation Trust

Debate between Sarah Wollaston and Alistair Burt

Tuesday 3rd May 2016 Commons Chamber

[Alistair Burt]

I thank the hon. Lady for her response. We are not actually debating the Government’s failure to respond at all. The Secretary of State did exactly what he said he was going to do, and the CQC’s inquiry and work that followed can be seen in the report that was produced last week. The report contains a number of further concerns—there is no doubt about that—and people are right to be angry, but there is a process to find out what is going on and to do something about it and that process is in place. That is what NHS Improvement is doing and it is important that that is done.

There is an issue of urgency, which is really important. There are things that are discovered and things take time to get done. I am not content with that in any way, but the process is in place to do something about that. The CQC has been engaged and has ruled out no option for further action. Its options are quite extensive, including prosecution for things that it has found. The process started by the Secretary of State is not yet finished. That my right hon. Friend has demonstrated his commitment to patient safety from the moment he walked into that office cannot be denied by anyone, and this is a further part to that.

I asked the same question that the hon. Lady asked about safety directly to the CQC this afternoon, and I spoke to Dr Paul Lelliott who compiled the report. I asked whether people are safe at the foundation trust today. People are safe because, as we know, the CQC has powers to shut down places immediately if there is a risk to patients. It has not done so, but I am persuaded that if it had found such a risk it would have closed things down. There is therefore no risk to safety in the terms that the hon. Lady suggests.

On the chief executive’s position, the power to deal with management change is held by NHS Improvement. I also offer a brief word of caution. There is a track record of Ministers speaking out, at great cost, about the removal of people in positions over which they have no authority. That is understandable in situations of great concern when an angry response seems right, but it is not an appropriate response. The chair has gone, and processes are available should any more management changes be necessary, which is important. Colleagues in the House can say whatever they like, but a Minister cannot and must say that appropriate processes can be followed, because that is right and proper.

I do not yet know about an inquiry, and I want to wait and see what comes out of the further work being done in the trust. I do not rule out some form of further inquiry, but an inquiry is physically being carried out now by the actions taking place on the ground. What needs to follow is urgent action to respond to what the CQC has said, and a long drawn-out public inquiry is not necessarily the right answer. More work might be necessary, but I need to consider that in relation to further work being done at the trust.

On preventable deaths, as I made clear in my statement, I am sure that not enough attention has been given to those cases that require further investigation across the system, often dating back many years and preceding this Government. We have turned our attention to that issue, and we will make changes because such inequality must end.

[Dr Sarah Wollaston (Totnes) (Con)]

The report on Southern Health makes disturbing reading, but we will never tackle unacceptable levels of health inequality and early deaths among those who live with learning disability and mental health issues unless we address safety and risk. Will the Minister go further on the mortality review and set out how we can see where differences exist around the country? Will he reassure the House that duty of candour will in future be more than a tick in the box?

[Alistair Burt]

A tick in the box for duty of candour, which the report mentioned, was unacceptable—it must mean much more than that. The learning disability mortality review programme is important and will support local areas to review the deaths of people with learning disabilities, and use that information to help improve services. In time, it will also show at a national level whether things are improving for people with learning disabilities, and whether fewer people are dying from preventable causes. That review is already under way in a pilot in the north-east in Cumbria, which will help to inform us how the programme operates as it is rolled out. Plans are in place to roll out that review across all regions of England between now and 2018, with pilots commencing in other parts of the country between 2016 and 2017. That work has never been done before, and it is right that we are doing it now.

Mental Health Taskforce

Debate between Sarah Wollaston and Alistair Burt

Tuesday 23rd February 2016 Commons Chamber

[Alistair Burt]

I thank the hon. Lady for her usual well-informed contribution to the debate on these issues, and for what she says about stigma and the general approach the Government have been taking. She is absolutely right about that. We have supported the Time to Change anti-stigma campaign, which has had some success, although we have to do more.

The hon. Lady is also right about children and wider cross-government work. On children and young people, for the first time we have a Minister in the Department for Education in England who has responsibilities for mental health, and the Under-Secretary of State for the Home Department, my hon. Friend the Member for Staffordshire Moorlands (Karen Bradley) is here to demonstrate that we take those cross-government responsibilities very seriously. One way in which we are going to manage the response to the taskforce is by having a cross-governmental team to make sure that Departments are joined up. Housing has something to do with this, as do education and work and pensions, as the hon. Lady said. We will make sure that that is done.

I should have said, but did not do so for reasons of time, that what has been said by the taskforce and what the Prime Minister has said is in addition to the £1.25 billion announced in March for the development of the child and adolescent mental health services in England and the £30 million a year eating disorder work, in order to recognise the increased pressures on children. As the hon. Lady rightly says, the more prevention work that can be done earlier, the better.

[Dr Sarah Wollaston (Totnes) (Con)]

I remind the House that I am married to the registrar of the Royal College of Psychiatrists. I join the Minister in thanking the independent mental health taskforce for the work it has done. Will he go further on how we are going to track this money, with greater transparency, to ensure it is spent in the right place, not just within health, but within social care? He will know that many of those who are suffering from mental health problems are cared for in the community, under social care, and it is therefore vital that we have parity of esteem across both health and social care.

[Alistair Burt]

Yes, I thank my hon. Friend for that and recognise the work of the royal college. Its president, Simon Wessely, was also much involved in the report, as was the college, so I thank them for that. It is very important to track this money. The CCG assessment framework will help us to do that through the health service. The money that the Prime Minister announced in relation to community crisis care—the extra £400 million announced in January—will be spent throughout the community, and it is essential that we track it.

There has been a data lack; the hon. Member for Liverpool, Wavertree (Luciana Berger) knows about that well, because I answer far too many of her questions by saying, “This information is not collected” or, “This information is not collected centrally”. [Interruption.] I have noticed that. We are in the process of changing that situation; the dataset was in the process of being changed and more information will be available. In order to track things properly, we have to have the information available. The question is right and we are improving the data. It is important to track this, both in local authority work and in NHS work.

Oral Answers to Questions

Debate between Sarah Wollaston and Alistair Burt

Tuesday 9th February 2016 Commons Chamber

[Alistair Burt]

The consultation is ongoing between Departments. A unit has been set up by the Department of Health and the DWP to look at a range of issues that concern us both. The actual detail of the future attendance allowance has not been finalised yet, but it is a matter of concern and discussion between Departments.

[Dr Sarah Wollaston (Totnes) (Con)]

In asking a question about mental health, may I remind the House that I am married to an NHS forensic psychiatrist, who is also registrar of the Royal College of Psychiatrists? Have the Government looked carefully at today’s report from the independent commission on improving mental health services, particularly its finding that provision nationally for the most severely ill acute patients is inadequate? Will the Government set out what measures they will take to make sure we really see progress on parity of esteem and on improving access to such severely ill patients?

[Alistair Burt]

I thank my hon. Friend for her question, and the Royal College of Psychiatrists for its work on Lord Nigel Crisp’s commission, which we have supported. The report and recommendations have only just come to us, but they certainly travel in the direction in which the Government are already going. We want to reduce out-of-area placements. The NHS is already committed to that, and is working on moving to a definitive target to reduce the number of them and, I hope, eventually to scrap them. I was up in Hull last week to look at problems in that particular area. The recommendations on waiting times are very important. As we all know, this area has been undervalued in the past. It is under greater scrutiny, and more investment and support are going in through the Government. Today’s report will help us in relation to that.

Oral Answers to Questions

Debate between Sarah Wollaston and Alistair Burt

Tuesday 13th October 2015 Commons Chamber

[Alistair Burt]

As part of the proposal to see an increase of 5,000 in the number of doctors working in general practice by 2020, work is being done not only to recruit more, but to retain them and to bring back those who have left general practice but want to return. Health Education England is working with the Department on all these plans and proposals. The hon. Gentleman is right to identify that as a key source of those who will come into the service in future.

[Dr Sarah Wollaston (Totnes) (Con)]

Delayed publication of evidence is as damaging as non-publication, which is why we rightly expect clinicians, researchers and managers to publish their evidence and data in a timely and transparent manner. It is a matter of great regret to the Health Committee that we started our inquiry today without access to the detailed and impartial review of the evidence that we need to make a contribution to this inquiry. Will the Secretary of State please set out when he will publish it?

Security of Women in Afghanistan

Debate between Sarah Wollaston and Alistair Burt

Thursday 6th March 2014 Commons Chamber

[Alistair Burt (North East Bedfordshire) (Con)]

I, too, congratulate my hon. Friend the Member for West Aberdeenshire and Kincardine (Sir Robert Smith) on introducing the debate and giving the House an opportunity to discuss this matter. As the House knows, for two years I had the privilege of being the Minister responsible for Afghanistan in the Foreign and Commonwealth Office. I pay tribute to all those I worked with at the time who were involved with Afghanistan. The House rightly pays tribute regularly to our armed forces for the extraordinary work they do, but it is also important to remember the contribution made by civilians from this country who go out to Afghanistan to engage locally in some of the many complex issues that have been mentioned and to work with different international organisations. I also want to pay tribute to experienced parliamentarians. Once again this debate is enlightened by colleagues who have been to Afghanistan and met those engaged in some of the difficulties we are talking about.

When I become the Minister with responsibility for Afghanistan, I was clear from the beginning that the development of women in society and the importance of maintaining the progress that had been made was central to many organisations that are campaigning for, and worried about, the position of women. I pay tribute to Amnesty and other organisations that have done so much work in that respect, but they were always pushing at an open door. I want to make it clear to the House how central the role of women in Afghanistan was to the development of policy, within both the FCO and DFID, right through the period when I was involved and beyond.

When the Foreign Secretary published the United Kingdom’s national action plan in response to UN Security Council resolution 1325 in relation to the development of societies post conflict, he said:

“No lasting peace can be achieved after conflict unless the needs of women are met—not only justice for the victims of crimes of war, but their active involvement in creating a society in which their rights are respected and their voices are heard.”

I pay tribute to the Foreign Secretary, who has been quite remarkable—I am grateful to the hon. Member for East Lothian (Fiona O'Donnell) for what she said about this—in his dedication to the rights of women and his concern about the use of conflict to damage women. He has been quite exceptional in that regard. I know from personal experience how much he was concerned about Afghanistan and how much support he gave me and others in our work.

That there has been progress in Afghanistan since 2001 is clear—it has been documented by other Members, so I will not detain the House long on this—with regard to health, education, justice and participation. Women have seen their circumstances improve. Some 3 million girls are now in education and there are now women teachers, whereas there were not before. To some extent, that helps to contradict the sense, which some portray, that it is a society that it is impossible to change. If it were impossible for it to change, those brave women would not have come forward, which is another reason why they deserve support.

We understand very well that there are different cultures in different societies, but we have a culture too. Our culture and our tradition in this country is to stand up for what we think is right and to say very clearly, even though value judgments are involved, when we think something is wrong. The subjugation and terrorisation of women is wrong. We know, however, as my right hon. Friend the Member for Gordon (Sir Malcolm Bruce) said, that that cannot be done from the Chamber of a Parliament thousands of miles away. It needs to be done by working with those on the ground. Again, the extraordinary work that has been done in capacity building and support over recent years has, I believe, made a significant difference and will continue to do so.

[Dr Sarah Wollaston (Totnes) (Con)]

My right hon. Friend is making a powerful speech. Does he agree that we should also pay tribute to voluntary organisations such as Afghan Connection, which is on the ground in areas such as north-east Afghanistan and putting in place education and training for teachers?

[Alistair Burt]

My hon. Friend is absolutely right, and I could name a number of different organisations—I will mention one in a moment. Men and women are going out from this country to do extraordinary work with people in Afghanistan and to support the bravery of women and others there who are working for change.

I remember on my first visit to Afghanistan meeting a group of women civil society activists and being told straightforwardly, “If you ask women in our society whether life has changed for the better since 2001, between 60% and 70% will say yes. But if you ask how many are afraid for the future, 99% will say yes.” The constant refrain, particularly as we got closer to naming a date when the United Kingdom’s armed forces would withdraw—2014—was, “Are you all going? Are the lights going out?” I remember being very committed to saying, on behalf of the Government, “Absolutely not. People are staying and the commitment to Afghanistan will remain.”

It is very important to recognise that that is done in conjunction and co-operation with brave individuals who are there. I could name many, but let me refer to just two or three in the short time available. Habiba Sarabi, who was mentioned by my right hon. Friend the Member for Gordon, is a remarkable woman who made her name working on women’s literacy, before joining the Government in 2004 after the Taliban had gone. She is now the governor of Bamiyan province. Sometimes the media can present the image that it is all about Helmand, but it is not. There are places where things are happening and women are engaged in society and want to remain engaged. She is a remarkable woman.

Fawzia Koofi, a member of Parliament whom I have met on more than one occasion, is an outstandingly brave woman. When she was a baby, her mother left her outside to die in the Afghan sun because she did not want another daughter in the house. She was rescued after a few hours, burnt almost to a cinder. From that experience she developed an extraordinary attitude to life and a determination to fight for the rights of women. She was recently interviewed and said a few things—this follows what other Members have said—about the current difficulties. She said:

“It’s becoming harder to work on women’s issues. Conservative colleagues are more confident to open their mouths… But there is more awareness among women to stand by themselves and defend their rights… You cannot talk about women’s education, women’s economic empowerment and social empowerment without their political participation. So for any young woman I would encourage them to have the courage to put herself forward.”

With examples like Fawzia to follow, young women can do just that.

I want to mention two individuals from the United Kingdom. The first is Linda Norgrove. I was involved in the hostage crisis when Linda was kidnapped. She subsequently died in an attempt to free her in October 2010. I attended her funeral and remember what a remarkable occasion it was, as people remembered what she had done. She worked with widows, in particular, in eastern Afghanistan. Her parents have set up a foundation in her memory, another one of those organisations that work to remember a remarkable person from this country who lost their life because of their commitment to the women of Afghanistan. She managed a team of some 500 staff who moved from district to district in eastern Afghanistan, working with communities to implement projects in conjunction with local people. That reinforces the point that it is not a question of imposing values from outside; it is about working with others there who want to make a success of things. The second individual I will mention from the United Kingdom is my noble Friend Baroness Hodgson, who has given a lot of time and effort in Afghanistan, and at great personal cost and risk to herself.

Finally, I want to mention Hillary Clinton. I remember my early meetings with Mrs Clinton when she was Secretary of State. It was clear that her commitment to the advancement of women was no political gesture, but firm and determined. We were constantly being asked how we would put into practice what we believed about the future of women in Afghanistan, so she made sure that it was in the Bonn declaration in Tokyo. Her commitment has been remarkable.

As has been said, we know that there are limits to what we can do. Ultimately, it will have to be Afghanistan that enforces what we believe. But our constant engagement, our determination not to leave people alone, the fact that we will continue to talk about it here and the fact that men and women from the United Kingdom will continue to go to Afghanistan to support the people there will be the clearest demonstration we can give that, although things are written in treaties, we will follow them ourselves. We will do all we can to support the brave women who are already working in that country. There is much to achieve, but we have achieved a lot. I am deeply grateful to colleagues for the way in which they have worked on this over a number of years. We owe it to the people of Afghanistan, and to all those from the United Kingdom who have lost their lives there, to work with others for a better future, which they deserve and have been richly working towards.