(6 years, 3 months ago)
Commons ChamberI rise to speak as a former public health consultant and the chair of a primary care trust.
I want to start by recalling a conversation I had with Brenda Rustidge, a constituent of mine. She was born in the 1930s, and she described to me what it was like living in a pre-NHS world. Her father, who had just been demobbed after the war, was unemployed. She had a number of brothers and sisters, and they used to have to hide under the window when the doctor’s secretary called round on a Friday night to collect the money. She described the real fear and shame that she felt as a result. Of course, all that changed nearly 70 years ago when the NHS was created. Brenda and her family have thrived because of that.
This debate is not about scaremongering. It is about raising awareness of the real concerns not just of political parties but of clinicians, academics and experts across the country and across the world about what privatisation means. Okay, it is on a small scale, but in terms of spending it has increased from about 2.8% in 2006 to over 7.5%—over 10% if we include not just private providers but all non-NHS providers.
I want to reflect on a point made by my hon. Friend the Member for Stockton South (Dr Williams): we have within the NHS a system that provides universal, comprehensive and free healthcare. That is something we should be very, very proud of. We are seeing that being eroded. For example, private providers of knee and hip replacements exclude certain people. They do not want the complex cases because they are too time-consuming and costly. I take issue with the point that the right hon. Member for Mid Sussex (Sir Nicholas Soames) made, because it does entirely matter who provides the care that we get. There is a slow and steady erosion of the NHS as the sole provider.
In 2014, I conducted an inquiry into the international evidence on the effect of privatisation, marketisation and competition across different health systems. We commissioned a review of reviews, which is the strongest type of evidence, on the impact on health services, particularly looking at equity and quality. It was submitted to peer reviews and accepted in peer-reviewed journals subsequently, and it showed clearly and conclusively that health equity worsens in terms of not only access to healthcare but health outcomes.
It also revealed that there is no compelling evidence that competition, privatisation or marketisation improves healthcare quality. In fact, there is some evidence that it actually impedes quality, increasing hospitalisation rates and mortality rates. Of course, that was the key argument and the sole reason that the Government put forward for the Health and Social Care Act 2012.
The report found a whole host of other issues. I am sure that Members will go to my website to read about that. The transactional cost was one example—
I am very sorry, but in order to accommodate the remaining speakers—I thought that there were four, but there seem to be five—I must impose a three-minute limit, as I advised the Whip. I want to get everyone in.
For now, NHS trusts remain the sole shareholder in their wholly owned subsidiary companies—yes, just for now—but those subsidiary companies will be easier to sell in future. The trusts have established those subsidiaries with long contracts under the misguided impression that such contracts protect the trust and the employees. What the trusts do not acknowledge is that the current Government, or a future Government, could order them to sell off a subsidiary company, contracts and all, and, if necessary, could change the law to make it happen.
We have already seen how these new subsidiary companies make their margins off the backs of now former NHS staff who face the prospect of less favourable contracts with no access to the NHS pension scheme, yet some trust executives claim they are transferring employees to protect them. That is absolute rubbish. We all know that when staff are transferred by TUPE, the receiving employer can have a reorganisation. It can create new roles and axe old ones, and it can require people to apply again for what looks like their old job with some subtle changes, with the terms and conditions varied, putting an end to the protections they once enjoyed. This creates the two-tier workforce many others have spoken about today. It means that some people are being treated better than others, with more rights, better pay and better working conditions.
I have even heard that some of these executives believe the changes could be in the best interest of the workforce. None of these executives faces the prospect of being reorganised out of their job or out of their final salary pension scheme with a 15% employer contribution. The executives will continue to get that pension, yet the people they have shifted into new organisations will get a 3% employer contribution to their pension.
In a few years’ time, it will be interesting to see just how many of the original staff are still in these organisations and how many of them are on the same terms and conditions enjoyed by NHS staff who are still employed directly.
I am proud that, just a week ago, one of the teams at the North Tees and Hartlepool NHS Foundation Trust in my Stockton North constituency was shortlisted for the NHS 70th awards, but a few months ago even this trust succumbed to temptation and set up one of these wholly owned subsidiary companies, despite the accounts for an existing subsidiary company showing it needed a bail-out from the trust to survive.
Wholly owned subsidiary companies are not working. They are a mechanism to rid employees of their NHS pension and of collective bargaining. The companies are damaging to employees, and they are damaging to the service in the longer run. What they are really doing is severely damaging the morale of our staff.
I thank the NHS’s public service workers for all that they do for us. They have stood against cuts under Tory austerity and a decade of SNP cuts in Scotland. Scotland’s NHS workers are underpaid, undervalued and under-resourced while millions of pounds are spent on agency staff. As Richard Leonard, the Scottish Labour leader, said recently, private companies are
“sucking money out of the NHS”,
but Labour in Scotland is ready to stand up to Tory austerity and SNP cuts.
(6 years, 3 months ago)
Commons ChamberTo ask the Secretary of State for Health and Social Care to make a statement on the learning disabilities mortality review. [Interruption.]
Order. There is a certain amount of chuntering from a sedentary position. The Secretary of State has been with us, but Minister Caroline Dinenage will answer the urgent question, and we look forward to her answer.
The Government are absolutely committed to reducing the number of people with learning disabilities whose deaths may have been preventable and have pledged to do so with different health and care interventions. The learning disabilities mortality review programme was established in June 2015; it was commissioned by NHS England to support local areas in England to review the deaths of people with a learning disability. Its aims were to identify common themes and learning points, and to provide support to local areas in their development of action plans to take forward the lessons learned.
On 4 May, the University of Bristol published its first annual report of the LeDeR programme, covering the period from July 2016 to November 2017. The report included 1,311 deaths that were notified to the programme and set out nine recommendations based on the 103 reviews completed in this period. The Government welcome the report’s recommendations and support NHS England’s funding of the programme for a further year at £1.4 million. We are already taking steps to address the concerns raised, but the early lessons from the programme will continue to feed into our work, and that of our partners, to reduce premature mortality and improve the quality of services for people with learning disabilities.
(6 years, 3 months ago)
Commons ChamberOrder. It is very good to welcome back to the Chamber the right hon. Member for Leicester East (Keith Vaz).
Some young people are mothers and do have mental health problems, upon which important matter the hon. Member for Faversham and Mid Kent (Helen Whately) has Question 19, which, sadly, will not be reached. If she wishes to give the House the benefit of her thoughts now, she is most welcome to do so, but it is not obligatory. [Interruption.] We will get her in later.
Given that children of mothers with perinatal health problems are at much higher risk of developing mental health problems themselves, why does the Government’s Green Paper on mental health not address prevention in respect of perinatal health?
I wanted to ask a supplementary to the question about Boston.
That goes to the heart of why we are reforming the dental contracts. Our 73 high street dental practices are continuing to test the preventive focused clinical approach to a new remuneration practice. [Interruption.] Someone on the Opposition Front Bench has just said “when” from a sedentary position. It will be when we have got it right.
The hon. Member for Tonbridge and Malling (Tom Tugendhat) has beetled into the Chamber like a perspiring postman just in time. It is very good to see the fellow.
I thank my hon. Friend for her question and her continued industry on these matters. As she mentioned, the Green Paper outlined plans to set up a new national strategic partnership focused on improving the mental health of 16 to 25-year-olds. That partnership is likely to support and build on sector-led initiatives in higher education, such as Universities UK’s #stepchange project, whose launch I attended in September. The strategy calls on higher education leaders to adopt mental health as a strategic priority, to take a whole-university approach to mental health and to embed it across policies, courses and practices. [Interruption.]
Order. The hon. Member for Wigan (Lisa Nandy) need not worry; her Zebedee-like qualities will always make her visible. I am saving her for later. We will hear from her shortly.
Does the Minister agree that eating a nutritionally balanced meal can reduce snacking between meals and therefore help to reduce childhood obesity? If so, will he speak to his colleagues in the Department for Education and ask them to ensure that the 6,400 children in Kirklees who are set to lose out on a well balance nutritious free school meal do not?
The pharmacy integration fund is a great success. It needed to be ramped up and it is being ramped up. Pharmacists, working within general practice, are making a great difference to the multidisciplinary team within primary care.
The Secretary of State will be aware that the hon. Member for Hazel Grove (Mr Wragg) and I set up an all-party group on the impact of social media on the mental health of children. With all the work the Secretary of State has done to date on that, I wonder whether he and his ministerial team will agree to engage with the all-party group’s inquiry and look at how we find solutions to these problems, including mental health.
Several of my constituents have contacted me to welcome the Government’s recent announcement of additional investment for prostate cancer funding. Will the Minister update the House on what the money is and what it will be spent on?
I have been enjoying listening to my colleagues so much that I inadvertently lost track of time, but it seems only right that the final question should go to the Chair of the Health Committee—I call Dr Sarah Wollaston.
Thank you, Mr Speaker. Will the Secretary of State commit to publishing the progress report on sugar reduction and the next steps strategy on the reformulation programme, so that the Health Committee can examine that when Public Health England appears before us on 22 May?
(6 years, 3 months ago)
Commons ChamberOrder. As colleagues know, I like to call everyone on statements, and I do not wish to make an exception today, but I remind the House that we also have a ten-minute rule motion and a very heavily subscribed Opposition day debate. In pledging to try to get all remaining colleagues in, I ask them to do us all the great favour of being extremely brief. I am sure that Mr Shannon has in mind just a short sentence without any preamble or subordinate clauses.
I thank the Secretary of State for his statement and for his compassion and care. Is he aware of any discussions on the continued alignment with the European Medicines Agency’s drug licensing process to ensure that our breast cancer patients, and indeed all cancer patients, have access to the benefits of the European trials and UK citizens are able to participate in clinical trials? This is very important.
The hon. Member for Bexhill and Battle (Huw Merriman) will be a master of the pithy question because he was educated magnificently in my own constituency.
And I am very proud to have been.
The Secretary of State knows well and cares deeply about safety matters. As he also knows, I have spent too much of my time with the clinicians in the cancer centres of Maidstone and Tunbridge Wells. Will the review perhaps look at administrative and back-office resources and at whether they play any part in improving survival rates?
The whole House is thinking of my hon. Friend who, like many people in this country, is going through a huge amount of personal pressure as cancer strikes close to home. He is right that back-office systems are often poor when it comes to contacting patients, which is in contrast to the superb clinical care that we are usually able to offer, so we will absolutely consider that as part of the review.
I wish the hon. Gentleman well in the period ahead. I was not aware of those personal circumstances, but the whole House will wish his nearest and dearest all the best.
(6 years, 4 months ago)
Commons ChamberJust before I call the right hon. Member for Old Bexley and Sidcup (James Brokenshire), let me say that I will not be in the Chair for this debate—it will be admirably chaired by the Chairman of Ways and Means—but I want to say, pursuant to the debate only a week ago, what a pleasure it is to see the right hon. Gentleman in his place, having contributed so forcefully and powerfully in last week’s debate, and I wish him Godspeed with this debate and in every other respect. The whole House is happy to see him in good heart, good spirit and good health, leading debates on these important matters.
(6 years, 4 months ago)
Commons ChamberOn a point of order, Mr Speaker. The motion that has just been unanimously agreed calls on the Government
“to meet the funding gap for social care”—
widely said to be £1.3 billion—
“this year and for the rest of this Parliament.”
Given that Ministers have agreed to the motion, can you advise when we might expect an announcement from the Government on this important agreement on social care funding?
The most pertinent response that I can offer to the hon. Lady—I understand her perfectly legitimate point of order—is as follows. On 26 October 2017—obviously this was done in the light of a number of Opposition-day debates and motions voted thereon—the Leader of the House said in a written ministerial statement:
“Where a motion tabled by an opposition party has been approved by the House, the relevant Minister will respond to the resolution of the House by making a statement no more than 12 weeks after the debate.”—[Official Report, 26 October 2017; Vol. 630, col. 12WS.]
That is the position as things stand. The hon. Lady has registered her point with considerable force, it is on the record, and I do not dispute the fact of what she said about the motion being carried unanimously.
(6 years, 4 months ago)
Commons ChamberThat is excellent. That is one of the things we called for. One thing that has come out more and more is that there needs to be informed consent. People need to know a lot more about the risks. All the risks need to be written down in front of someone in block capitals so that they know exactly what they are letting themselves in for.
I press again, as I did at the beginning of my speech, for all new mothers to be offered pelvic floor physiotherapy, as happens in France. As the Minister has just said, it is unacceptable that a new mother with a small, relatively minor inconvenience should be offered something that could result in permanent, life-changing disability. I urge the Minister to look into that as well.
I very much welcome the fact that we will have the draft NICE guidelines next year. As we have spent a lot of this debate talking about our mums and what they say to us, I will quote my mum. She always said, “Where there’s a will there’s a way”. If there is a way of bringing forward those NICE guidelines, let us make it happen, because if there is a determination across the House to make it happen, I am sure that the Department can find a way to do it and end this misery for so many women.
I end by thanking again all the fantastic women up there in the Gallery right now watching this debate. We are only talking about this now because of your bravery in coming forward and speaking out, and I thank each and every single one of you. We cannot undo the suffering you have experienced, but by speaking out and being so incredibly brave, you will stop women in the future going through what you have gone through. I and every Member who has spoken today thank you.
I thank the hon. Lady and everybody who has joined us today. I hope that they have felt uplifted by the debate.
We now come, colleagues, to the Back-Bench motion on cancer treatment. [Interruption.] Apparently, before we move on I should put the question on the debate on surgical mesh. I thank the specialist Clerk for his help and for rescuing me. We will now be entirely orderly.
Question put and agreed to.
Resolved,
That this House commends the recent announcement of a retrospective audit into surgical mesh for pelvic organ prolapse and stress urinary incontinence; notes that vaginal mesh has been banned in other jurisdictions such as New Zealand; further notes that NICE guidance recommends against the use of surgical mesh for pelvic organ prolapse and that no NICE recommendations have been made for stress urinary incontinence; notes that Sheffield University recently announced the development of a new mesh material; and calls on the Government to suspend prolapse and incontinence mesh operations while the audit is being carried out, to bring forward the NICE guidelines for mesh in stress related urinary incontinence from 2019 to 2018, and to commit to a full public inquiry into mesh if the audit suggests that this is the best course of action.
(6 years, 4 months ago)
Commons ChamberJust before I ask the hon. Member for Croydon Central (Sarah Jones) to open the debate, it is my honour, privilege and joy to welcome Baroness Jowell—Tessa Jowell—together with David, Matthew, Jess and others to the Under-Gallery, in what will be an extremely powerful and, I hope, constructive debate. Can I say to you, Tessa—and I say it on behalf, I am sure, of all colleagues—that I hope you will feel fortified and inspired by the warm embrace of parliamentary love which you are about to experience? It is now my pleasure to call Sarah Jones to open the debate.
Order. It may have to be reduced, but we will start with a limit on Back-Bench speeches of six minutes each. I call George Freeman.
I am grateful for the opportunity to sum up the debate on behalf of the Scottish National party, and to acknowledge speeches by the hon. Members for Croydon Central (Sarah Jones), for Dulwich and West Norwood (Helen Hayes), for Mid Norfolk (George Freeman), for Croydon North (Mr Reed), for Congleton (Fiona Bruce), for Hove (Peter Kyle), for Torbay (Kevin Foster), for Lewisham East (Heidi Alexander), for Redditch (Rachel Maclean), for Hampstead and Kilburn (Tulip Siddiq), for Ilford North (Wes Streeting), for Mitcham and Morden (Siobhain McDonagh) and for Strangford (Jim Shannon), and by the right hon. Members for Don Valley (Caroline Flint) and for Old Bexley and Sidcup (James Brokenshire).
As a new Member of the House this has been a very strange week for me, and it is the first time that I have felt quite a lot of emotions. Sometimes the public watch these debates and see Members of Parliaments slinging mud at each other across the Chamber, but no one could help but be moved by some of the incredibly personal speeches that have been made today, and that reminds those watching that we are all human beings after all. People have shared deeply personal stories, and it has been a real privilege to sit through this debate.
Like other Members, I pay tribute to Baroness Jowell for her bravery and for the moving speech that she made in the Lords. I know that when we watched that speech most of us were moved to tears, and I am glad she is here today. I also wish to acknowledge the late Dr Mo Mowlam. I was disappointed that she was airbrushed out of much of the media coverage of the 20th anniversary of the Good Friday agreement, because as an outsider looking in, I cannot help feeling that that agreement would not have been achieved without her. I am currently reading her book, and I cannot help but be moved by the effort that she put into Northern Ireland, and she did all that while going through an illness as well.
As an MP from Scotland, I want to offer a bit of experience from north of the border about our cancer strategies, and describe the commitment and improvement that we want for children and young people with cancer—I will return to that point. There is no doubt that we face many challenges, not just in Scotland but across the UK, when it comes to cancer. One problem we need to grapple with is obesity, which is the second highest cause of cancer. We must be as bold about diet and obesity as we have been about tobacco and alcohol, and everyone should consider that. That is definitely a challenge for me—my colleagues are not here, but they know that I do not have the best diet in the world, and diet and food choices are a real challenge when combating obesity.
We must also channel some focus on to free school meals and the choices made by children. Sometimes we think that cancer is just bad luck or something that comes to people, but there are things we can do to try to avoid it. For example, we know that advertising junk food harms people and puts pressure on the NHS, other public services and our economy. There is clear evidence of the need to curb the marketing of food and drink that is high in fat, salt and sugar. A large number of 11 to 18-year-olds have seen television adverts for those foods, and nearly half of those surveyed had made a purchase based on the marketing they had seen in previous days. We should consider banning such adverts during programmes for children and those under 16, because if we are serious about tackling obesity and reducing the prevalence of conditions such as type 2 diabetes, we must make it as easy as possible for young people to eat healthily and have a good diet. That means seriously reconsidering the marketing of unhealthy food and drink, and reducing exposure to such advertising on TV.
Before I conclude I want briefly to consider cancer and young people. We know from CLIC Sargent that around 4,000 children and young people are diagnosed with cancer every year in the UK. Every day, 11 children and young people hear the news that they have cancer, and every week 10 children and young people die from cancer in the UK. Cancer is the most common fatal disease for teenagers and young adults in the UK. CLIC Sargent’s 2016 research found that young cancer patients often had a long and difficult route to diagnosis, which they felt had a detrimental impact on their treatment and experience.
Cancer costs families in many ways, including financially, as parents report an average additional expense of £600 for every month that their child is on treatment—the hon. Member for Ilford North touched on that. Some of the expenses are travel, extra food, energy bills and car-related costs, including parking. Families are travelling an average of 440 miles a month to access treatment for their children. At this juncture, I want to commend the right hon. Member for Harlow (Robert Halfon), who has been an assiduous campaigner in calling on the Government to scrap hospital car parking charges in England—they do not affect us in Scotland—for young cancer patients and their families.
We have had a good and very moving debate, and I am sure we will return to this subject again, hopefully with more progress. I close by thanking the hon. Member for Croydon Central for giving us the opportunity to discuss this hugely important topic. Above all, I want to thank the noble Baroness Jowell for joining us here today. We are all the richer for having her with us.
Just before I call the shadow Minister, I would like to emphasise that I would like the hon. Member for Croydon Central (Sarah Jones) to be able to briefly wind up the debate no later than 4.57 pm. Members can do the arithmetic for themselves.
I should like to thank everyone who has spoken so eloquently and movingly today. I cannot name everyone in the time remaining, but I often stand in awe of the Members of this House, and no more so than today. We have had quite a harrowing week in this place, and it has sometimes been quite dark and difficult. There has been a lot of shouting. However, we have closed the week by talking about human kindness, compassion, love and hope. That is what a drop of Tessa magic does for this place. When I saw Tessa just before the debate, she said that this was not about her or about us, and that she wanted it to be about what comes next and what we should do. I hope—and I have faith—that the Government will prove that Tessa’s model of collaboration is more effective than the model of confrontation that we have unfortunately seen so much of this week.
I have here a note from Tessa that I would like to read out. This is odd, because she is just over there, and she could say this herself, but I shall read out a little bit of what she wanted me to say today:
“Living with cancer has taught me so much. I have been so lucky to be surrounded by such love from my family, friends and fellow cancer patients. And today, hearing so many of you talk about your own fights, reminds me why I love this Palace of Westminster and the people who work here. It was a brilliant Member of this House, who spent far too short a time here, who said ‘we have far more in common than that which divides us’, and today shows how much we can do when we all put our shoulders to the wheel. It was the honour of my life to be one of you, and I shall cheer on from the sidelines as you keep fighting the good fight. So remember our battle cry: living with, not dying of, cancer. For more people, for longer. Thank you.”
In rounding off these proceedings, before we move to the Adjournment, perhaps I can thank warmly and from the bottom of my heart the hon. Member for Croydon Central (Sarah Jones) for securing the debate, for what she said in opening it and for the manner in which she did so. I think I speak for everybody in thanking all participants in the debate, both those who made speeches and those who intervened with great piquancy and significance—I say that looking directly at the Secretary of State for Health and Social Care, and, in his absence, thinking of the shadow Secretary of State. Their presence meant an enormous amount.
At the outset of the debate, I asserted with absolute confidence that Tessa was about to witness and experience real parliamentary love—the embrace of parliamentary love. I hope that the warmth of that embrace of parliamentary love has been manifest to her. She cannot have been in any way disappointed by it. Tessa, you are the standing testament to the indomitability of the human spirit and we have heard about that from people who know you so well in so many aspects of your life. I am quite certain, although I do not know it from personal experience—I can see it from the impact on those around you—that it is true of you as a wife and as a mother. It is assuredly true of you as a distinguished Member of Parliament—the Member, for so long, for the people of Dulwich and West Norwood. I thought that what your successor said about the affection and esteem in which you continue to be held there was worth everything.
It was most certainly true of you as a Government Minister, the details of which have been lovingly recalled to the Chamber this afternoon. Of course, we all know of the significance of what you did on the Olympics and, if I may say so, the significance of what you did by way of Sure Start and early years opportunity. When I briefly did a little work in a support capacity on speech and language services a decade ago, I trogged around the country—what a privilege it was—and visited huge numbers of such settings. There is absolutely no doubt whatsoever that the work you did and the translation from conception to execution transformed the lives of some of the most vulnerable of our fellow citizens. That is part of your amazing public service legacy.
As somebody who is living with cancer you have shone a light on a cruel curse and the need for collaborative, resourced and unflagging devotion to the effort to tackle that curse. The hon. Member for Croydon Central, quoting your letter, said that you loved this place. I hope that it is blindingly obvious to you, Tessa, that we love you—[Applause.] These breaches of parliamentary protocol are becoming more commonplace, but I think that this week we can rejoice in them.
Question put and agreed to.
Resolved,
That this House pays tribute to the work of Baroness Tessa Jowell in her campaign to help people with brain tumours to live better lives for longer; recognises the Government’s increased funding for research; and calls on the Government to increase the sharing of health data and promote greater use of adaptive clinical trials.
(6 years, 4 months ago)
Commons ChamberOn a point of order, Mr Speaker. With the blessing of the Government Whip here present, may I ask whether any steps have been taken to reinstate the curtain-and-commode system that used to envelop the Chair, so that on occasions like today, when you have sat there continuously from when the House first met until the House adjourns this evening, you might be able to do so in a little more comfort?
Well, I am grateful to the right hon. Gentleman for his point of order, but I am not aware that any such steps are planned. In so far as my personal comfort is a matter of interest or concern to the right hon. Gentleman, which is very touching, and might conceivably be to other colleagues, I can assure him and them that I have not felt other than comfortable, privileged and exhilarated to have been in the Chair for the past nine and a quarter hours.
Question put and agreed to.
(6 years, 5 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I see that two doctors are standing on the Government Back Benches. I am sure that the House will understand if I call the medic rather than the military strategist.
I warmly welcome this announcement and congratulate my right hon. Friend, the trade unions and NHS Employers on reaching this deal. One problem facing our NHS is that of people not returning to work after they have had caring responsibilities. What elements of the deal will encourage more people to consider coming back into the workforce? I am thinking, in particular, of the non-pay elements and the reform of pay structures that he has mentioned.