Health, Social Care and Security

Debate between Sarah Wollaston and Gloria De Piero

Wednesday 28th June 2017 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

It is a pleasure to follow the right hon. Member for Kingston and Surbiton (Sir Edward Davey).

When the national health service was launched in July 1948, it was launched on the basis of three core principles: that it should meet the needs of everyone, that it should be free at the point of delivery, and that it should be based on clinical need and not the ability to pay. Those principles continue to serve us very well; they are supported across the House, and they have been reinforced by the NHS constitution.

The extraordinary success of the NHS and public health provision lies in its delivery of increased life expectancy. Many people who now survive into adulthood would not have done so when I qualified as a doctor, some years ago. However, that extraordinary success hands us the key responsibility and challenge of ensuring that we can continue to provide and to meet the needs of everyone in the coming decades. The right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) spoke of the importance of joint working across the House. Given that we now have a different parliamentary arithmetic, I agree with her, and I would extend that to the way we talk about funding of health and social care.

[Gloria De Piero (Ashfield) (Lab)]

Last week I was told by Pauline that her mum, 79-year-old Sheila, who has dementia and heart failure, suffers from seizures and is unable to eat, go to the toilet or dress on her own, has been denied a funded place in a care home. Does the hon. Lady agree that that is a scandal that needs to be resolved?

[Dr Wollaston]

The hon. Lady has made a very important point. We will all see similar cases in our surgeries. However, we will not resolve the problem by having constant arguments about how we are going to do so. What we must do is agree, across the House, on how we are to provide long-term sustainable funding. I commend the House of Lords Select Committee on the Long-term Sustainability of the NHS for its work on the provision of long-term sustainable funding for health and social care. I welcome the commitment from Ministers in the Gracious Speech to seek sustainable social care solutions, but I call on the Government to extend that to health, because if we continue to view the two systems in isolation, we will fail exactly the patients, and others, to whom the hon. Lady has just referred.

The parliamentary arithmetic is such that there is an additional responsibility on all of us to ask what we can achieve by the end of this Parliament and what we can achieve when the NHS reaches its 70th birthday next year. I would say that by working together we could achieve something really remarkable, and I call on all Members from all parties to work to make that happen.

I also very much welcome the proposals in the draft patient safety Bill, but I put it to the Secretary of State that we need to get to grips with the impact of the workforce challenge across health and social care on patient safety. I agree with others that it is time for us to think again about the impact of the public sector pay cap. There is no doubt in my mind that seven years of the cap are now having a significant impact on morale in the health service and across our wider public sector. Again, I think that the change in the parliamentary arithmetic following the message that we have had from the electorate is very clear. People value our public services and they want to see this matter addressed.

One way in which we can address the issues of recruitment, retention and morale is to deliver a fair pay settlement, and I hope that we can make further progress on that. Again, however, we will achieve the funding that is required for that through realistic cross-party working. During the election campaign, and in the manifesto, we tried to address the issues of intergenerational fairness in funding these services, and it might be that, as we look realistically at how we are going to fund our public services, we need to take ideas from all parties in order to achieve our aims, so that we can do something about public sector pay and improve the retention rates in our health and social care workforce.

Another area of the Queen’s Speech that I want to touch on is mental health, and I should declare a personal interest, in that I am married to an NHS consultant psychiatrist who is also the registrar of the Royal College of Psychiatrists. I very much welcome the fact that we are the party that legislated for parity of esteem, but we now need to translate that into practice. It needs to be translated into ensuring that the welcome extra funding for mental health actually reaches the frontline and delivers.

I am pleased to see the proposals in the Gracious Speech for a Green Paper on children and young people’s mental health, and I hope that the Secretary of State will look at the joint work of the Select Committees on Health and Education in that area and take note of our proposals and suggestions. I also hope that he will look again at the work done by the Health Committee on suicide prevention. Suicide remains the single biggest cause of death in men under the age of 50 and in young people of both sexes. This is a core challenge, and one of the issues that we identified is now in the Government’s proposals—namely, how we involve the families of those with serious mental health challenges in their care and treatment. That does not involve riding roughshod over the important principles of confidentiality. Often, it can involve simple things such as ensuring that mental health professionals are aware of the consensus statement on how to achieve consent.

I welcome the progress that we have made on reducing the use of cells as a place of safety for those with serious mental health problems. Their use is wholly inappropriate and I hope that we can make further progress on that. There is much more that we can do to improve mental health care, but we have some excellent proposals in the five-year forward view. This is all about implementation, and I urge the Secretary of State to do everything he can to ensure that the money reaches the frontline, that there is transparency about that and that we make further progress on improving the mental health of young people and adults alike.