(3 years, 7 months ago)
Commons ChamberThis is a ground-breaking Bill. There is much of merit in it, although you would not believe it to listen to some of the contributions from the Opposition Benches. There are many good amendments, and I would single out new clauses 14 and 15 from my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) about linking housing targets and planning permissions.
In the limited time available, I want to talk about my amendment 5 on interim targets. Setting targets is easy. Governments like to set headline-grabbing targets, but too often the small print belies the ambition of the target, and the target date is in the dim and distant future. That can instil complacency and lethargy, because there is plenty of time to hit the mark and there is therefore no need to panic. When it comes to climate change, however, there is every need, if not to panic, at least to put our foot on the gas, metaphorically, and to act with urgency and immediacy.
The 2050 net zero target is almost 30 years away, and it should be a “last possible date by which”. It should be subject to a constant audit as to how quickly and by how far we can constantly bring that end date forward. It must also be an end date for a clearly set out progression to reducing harmful emissions and creating a net carbon environmentally benefiting economy. We need things to show a marked improvement from today, and so it should be with the natural environmental improvement targets in this Bill. My amendment is simple. It adds just four words in an additional subsection to clause 4, making it the duty of the Secretary of State to ensure that “interim targets are met.” That amendment would guarantee continuous incremental improvements in the natural environment, helping to keep all things environmental high up the Government’s list of priorities. It would bring the Environment Bill target framework into line with the approach of the Climate Change Act 2008, where there are five-yearly legally binding targets as milestones to the long-term legally binding target of net zero by 2050.
At the moment, the only recourse for the Office for Environmental Protection, if the Government miss an interim target, will be to criticise them in its annual report. That could of course be ignored by Ministers and Governments until the long-term target was missed, when enforcement action would actually kick in. Frankly, the power of policing this has to have more teeth than the ability of the environmental policemen to shout, “Stop, or I’ll shout ‘stop’ again!” Friends of the Earth has said:
“If these targets are not binding upon the Secretary of State it would be a huge missed opportunity to ensure the EIP system drives sustained, tangible environmental improvement—and would undermine the rationale for setting such goals in the first instance.”
I do not think so, but my hon. Friend is very kind. It is only because Madam Deputy Speaker is looking daggers at me.
Five-yearly interim targets also need to be set in the environmental improvement plans. However, the environmental improvement plans are not legally binding—they are simply policy documents—and all the plans need to be reviewed and potentially updated every five years and reported on every year. This is not the same as legal accountability.
(4 years, 2 months ago)
Commons ChamberA ten-minute rule Bill would have been good. In respect of new clause 29, which my hon. Friend is also speaking to, the Government will say that the matter is subject to negotiation, and that acting now would pre-empt and tread on that. I always listen with great respect to what he says, and I take a lead from him in many regards. Why is that not the pertinent point?
I have not actually come on to new clause 29 yet, and other people will speak to that point, but the problem is that the Government position has been weakened. They produced a negotiation document, which now has a discretionary scheme, rather than the mandatory scheme. The EU will be even less likely to want to agree to that, and it is absolutely essential that we have a scheme in place, otherwise on 1 January next year there will be no safe and legal route for the several hundreds of children who have been coming to this country safely to avail themselves of. That is the problem.
New clause 2 would ensure that all looked-after children and care leavers were identified and given status so that they do not become undocumented. Issuing settled status now would prevent another cliff edge in the future. These young people would have to re-apply for settled status in five years’ time, perhaps without the help of the local authority. The evidential burden would be lowered for local authorities applying and for Home Office caseworkers, saving time with the complex application process. The amendment to the process for identification and granting status is time-limited. As set out in the new clause, it would be effective for five years after the settlement scheme deadline, until 30 June 2026.
These are really vulnerable children. We do a great job of looking after them in this country, from which we can take great pride. For goodness’ sake, let us continue being able to do that job and keep them here legally without allowing them to become at risk. This is not about bringing lots of new children into the country—they are already here. We just want to make sure they have representation, recognition and the documentation to ensure that when they grow into adults and apply for a job, it is not all of a sudden found that actually they have no right to be here and they face deportation.
New clause 29—what a sense of déjà vu—was raised many times during the Brexit Bills. We were convinced by Ministers that that was not the appropriate place for it. I accepted that. We were told that it would be in the immigration Bill instead. It is not in the immigration Bill. We have been told that it is going to be down to the negotiations instead. Time is running out; the Dublin III scheme ends in exactly six months’ time, and there is no replacement for it yet.
As I said, the Government published their negotiation document. The most fundamental problem with the scheme that is now being negotiated—it is not guaranteed —is that the text removes all mandatory requirements on the Government to facilitate family reunions and would make a child’s right to join their relatives entirely discretionary. The text intentionally avoids providing rights to children, contains no appeal process and attempts to be beyond the reach of the United Kingdom courts. Other categories of vulnerable refugees, including accompanied children, would lose access to family reunion entirely, and a series of other key safeguards have been removed, including strict deadlines for responses and responsibility for gathering information being on the state rather than the child.
(4 years, 10 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
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Again, the hon. Gentleman makes a good point, which was on page 5 of my notes. This issue affects everybody across society, often better-off, more affluent families who might be better at hiding it or less inclined to come forward to seek help. The charity that I chair has units in Liverpool, Newcastle, London and so on, and we see that middle-class parents who have serious attachment dysfunction problems with their children are less likely to come forward. Those, ironically, may be harder-to-reach people. Health visitors are the early warning system and are able to signpost some of those people to services. They can also point out, “I think you have a problem,” and it will be taken on trust.
I appreciate the good points that have been made, but I will make some progress. The cost of failing to intervene early is enormous—financially and, more importantly, socially. The impact of not intervening early can disadvantage a child through early years, school years, adolescence and often into adulthood. In some cases, it can be life-defining.
One of the great achievements of the coalition Government was to pledge a massive increase in health visitors. In opposition, the then shadow Health Minister, Andrew Lansley, championed the recruitment of no fewer than 4,300 new health visitors, based on the successful model of the Dutch Kraamzorg system—I was involved in research into that—where post-natal care is provided to a new mother and her baby an initial eight to 10 days immediately after birth.
Four years ago, the Government’s health visitor implementation plan and the “Call to action” scheme were the pride of the nation. The policy was built on sound evidence that the health visiting profession had the power to drive health improvements and provide a universal service designed to give every child that best possible start in life, as we all want to see. Impressively, for a Government target, it was achieved—just about—in the lifetime of the 2010 to 2015 Parliament.
Depressingly, since then, the numbers have started to drop dramatically. In June 2015, there were 10,042 full- time equivalent health visitors in England. A year later, that had fallen to 9,491 and the latest figures show a 31% drop from the peak. According to the Institute of Health Visiting,
“one in four health visitors do not have enough time to provide postnatal mental health assessment to families at six to eight weeks, as recommended by the government.”
In response to a survey that the institute put out,
“three quarters of respondents said they are unable to carry out government recommended maternal mental health checks three to four months after birth.”
That is a crucial stage at which to pick up mental health problems with the parents, which may already be impacting or will impact on the infant. It is not only about looking after the baby, but the family unit and particularly the prime carer.
To a large extent, the reason for that has been the transfer of responsibility for health visitors from the health service to local government, as part of its enhanced public health responsibilities. I am not challenging the wisdom of doing that, but it has come at the time of the greatest squeeze on local government spending recently. The architecture of the delivery of health and wellbeing services for babies and young children, I think, has been fragmented in a disorienting manner between local councils, Clinical Commissioning groups and NHS England, with insufficiently qualified scrutiny of how it works. There is an issue around the quality of informed local authority oversight over many of these public health roles.
I congratulate my hon. Friend on securing this debate. He has been consistently right in this area. My research ahead of this debate presented a worrying picture from GPs in Winchester, who report a distant relationship with health visitors. That is not their fault; it is because health visitors are so thinly spread. Does he agree that as well as providing more health visitors, it would be smart to address where they sit in the system and, maybe, to co-locate teams around the emerging primary care networks?
First, I pay tribute to the real acknowledgment of the importance of this area by my hon. Friend when he was public health Minister. He was always prepared to take our sometimes annoying approaches to prioritising the issue. He may be right. I am not too concerned with processes and structures; I am concerned with getting the professional face to face with the parent and baby. We need to be smarter about where we can make that engagement happen and ensure it is not through lack of workforce that we are unable to do it.
If my hon. Friend wants to intervene again, he may, but it will eat into his own speech time.
The issue is important because the primary care networks and the GPs who rightly run them are responsible for the outcomes of the patients they manage within those lists. If they had ownership of those health visitors, because they were commissioned within that structure, they would have every incentive to close the distant relationship that I mentioned.
My hon. Friend may well be right. One of my constituents is a health visitor. According to her, the current status of health is not serving families well, based, as it is, on universally delivered process outcomes, which risk, to use a phrase she quoted to me, “ticking the box but missing the point”. That plays to the point my hon. Friend is making.
To illustrate the most successful ways of dealing with vulnerable families, I will use children’s centres as an example, although I will not get into a whole argument about them. The most successful ones that I have seen are those where hot-desking occurs between a district nurse, a health visitor, a social worker, a school nurse and others, who are all signposting. The health visitor may get over the threshold and say, “I am a bit worried that there is a mental health problem there. When I go back and see the community mental health nurse at the children’s centre, I might suggest she has a word.” That is the way it must happen. These are interlinking problems and it is not just down to one professional to treat them.
On the local authority, public health budgets have seen a significant reduction from 2015. The recent 1% increase for 2021 is welcome, but there is a long distance to go to replace some of the past reductions. Some areas have suffered disproportionately. I want to flag Suffolk, where, I gather, the council has been considering plans to slash the health visiting workforce by 25% to save £1 million. I think that is a false economy and short-sighted.
The decline in the number of health visitors since 2015 has been due to qualified nurses retiring or moving to other roles within the health service and too few trainees entering the profession. Alongside workforce cuts by local authority commissioners, the health visiting profession is also facing recruitment and retention problems, falling staff morale and poor progression opportunities. Health visitors have also raised safeguarding concerns as their caseloads increase to meet increasing need and cover shortages.
In a 2017 survey by the Institute of Health Visiting, health visitors reported that children are put at risk due to cuts in the workforce and growing caseloads, finding that 21% of health visitors are working with caseloads of over 500 children, as the hon. Member for Lincoln (Karen Lee) pointed out.
(6 years, 6 months ago)
Commons ChamberLipoedema affects 10% of women in this country, many without a diagnosis, so why are an increasing number of my constituents saying they cannot get any therapeutic interventions funded by the CCG? Will the Minister meet a delegation of those people and other hon. Members similarly affected?
Yes, of course I will meet my short-tied hon. Friend with the delegation he requests.
(6 years, 9 months ago)
Commons ChamberSustainability and transformation plan footprints were determined as a result of discussions between local areas, NHS England and NHS Improvement. They reflect a number of factors including patient flow, the location of different organisations in the local health economy and natural geographies. We stated in the next steps of the “Five Year Forward View” that adjusting STP boundaries is open to discussions between us and NHS England when that is collectively requested by local organisations, and we mean that.
(7 years, 1 month 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.
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They have not all been sensible, but yours was marginally more sensible.
As I said earlier, this is a rapidly growing sector and it is imperative that we get the right people into the right jobs. That is why it is so important to work with organisations such as Skills for Care to improve the level of skills, and people in this sector are expected to benefit from the national living wage.
Worthing has the highest proportion of over 85-year-olds in the country. They tend to be not particularly well off, and their major asset is their property; so can the Minister ensure that, in welcoming the fact that we will have a grown-up debate at last, any sustainable solution recognises that people who have worked hard, paid their dues, looked after their family and done the right thing should be appreciated, not penalised, for having done so?
I have said that we will consult on detailed proposals later this year, which will include a capital floor and an absolute limit on the amount that people can be asked to pay. Those two critical pillars must go together.
(10 years ago)
Commons ChamberI congratulate my hon. Friend the Member for Congleton (Fiona Bruce) on introducing this debate. It is absolutely essential that Parliament has the opportunity to talk through these important details at greater length.
As my hon. Friend knows, I am usually very conservative on ethical matters such as this. I do not usually advocate anything that might be seen as playing God. I have severe reservations about euthanasia. I have always opposed and will always oppose anything that would modify human characteristics and be seen as creating some form of designer baby. However, there are times when one has to be pragmatic. I have met families of the victims of these terrible, deforming, disfiguring and life-shortening diseases. It is right that we should use our human knowledge for the good of fellow mankind. It is great that, as my right hon. Friend the Member for Havant (Mr Willetts) has said, British science is leading the way.
Science is about finding cures and solutions, and this is just a different way of preventing horrible things from happening to our children. It is fundamentally a human intervention and it should be judged purely on the basis of whether we are doing more good than bad. I believe that we are when one in 6,500 of our constituents each year contract, without any choice, these horrible inherited diseases. The longer we say, “We need more checks, more safety, more testing”, the longer we are delaying a cure.
We need to get on with it. It has been widely consulted on. I have received virtually no letters on this matter and we need to take a balanced judgment on when the risks of mitochondrial donation become proportionate to the severity of the diseases that are affecting our constituents now. As colleagues have said, it will be licensed by the HFEA based on the safety and efficacy of the evidence, and those licences can be withdrawn at any time.
“Mitochondrial donation only allows for unaltered nuclear DNA to be transferred to an egg or embryo that has unaltered healthy mitochondria. These techniques only replace, rather than alter, a small number of unhealthy genes in the ‘battery pack’ of the cells with healthy ones. Mitochondrial donation does not alter personal characteristics and traits of the person.”
That is an important consideration, because:
“Mitochondrial donation will enable mothers to choose to have children who are genetically related to them, with a natural combination of nuclear genes from both parents while being free from a potentially devastating disease.
Nuclear DNA is not altered and so mitochondrial donation will not affect the child’s appearance, personality or any other features that make a person unique—it will simply allow the mitochondria to function normally and the child to be free of mitochondrial DNA disease. The healthy mitochondria will also be passed on to any children of women born using the technique”—
so we are doing good for generations to come as well.
I agree with what my hon. Friend is saying, and I do not agree with the motion of my hon. Friend the Member for Congleton (Fiona Bruce), although I have great respect for her, as a fellow Christian in this House. The work at Newcastle university is being funded by the Muscular Dystrophy Campaign and by the families and the people whom it supports and works with. Does my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) agree that the fact that they are putting money behind this, speaks volumes about the motives behind the work and about not letting the bad be the enemy of the good?
My hon. Friend is absolutely right. I think it is a great triumph that a British university is doing this important work. To those who say, “No other country allows this sort of thing,” I say, “Well, great; we are pioneering here, as British science has done in so many different areas.”
We need to be honest. We can raise a question about the ethics of it, but we should not hide behind safety considerations when certain people really oppose it for ethical reasons. Let us have that honest debate. I am prepared to give my support to these regulations and to us getting on with this science, with the assurances that there will be strict licensing conditions based on strong scientific evidence and that this in no way can lead to anything that can be remotely construed as designer babies, which I find completely and utterly abhorrent.
We should get on with it. Mankind has used its knowledge and skill to invent some pretty devastating and ghastly ways of disfiguring, maiming, neutering and killing human kind. We should celebrate this remarkable advance in using our scientific knowledge—our human skills—for good, and potentially for the good of generations to come in the families afflicted with these terrible illnesses.
(11 years, 6 months ago)
Commons ChamberFour minutes are not enough to lay out an argument about this matter, so let me set out some ground rules. I very much agree with the questions raised by the right hon. Member for Exeter (Mr Bradshaw). If this Bill passes through Parliament and becomes law, it will not be the end of the world as we know it; a new Sodom and Gomorrah will not take hold of our island. Similarly, if it does not go through, it will not signal some resurgence of intolerance or inequality. No one will lose any rights to equal treatment and respect under the law and in the eyes of society.
No doubt some of our constituents who urge us to vote against the Bill do so out of an intolerance of same-sex relationships per se, or even homophobia. Likewise, some of those who urge us not to vote against the Bill, with charges of bigotry, closed-mindedness and religious zealotry, are equally guilty of intolerance and bigotry. I am sure that the vast majority, if not all Members of this House, are not homophobic, and neither are the vast majority who support the Bill bigots. Let us therefore have this important debate on the basis of respecting each other’s position, and hope that that rubs off—for once—on some of our over-zealous constituents and lobby groups.
Let us get away from the ridiculous mentality that too often pervades arguments on sensitive issues: that if someone is for some reason not in favour of a specific issue, they are against the whole cause—that if someone is not in favour of gay marriage, they must be homophobic or against equality. What nonsense! I feel immensely special and proud to be British, but that does not make me racist or guilty of regarding citizens of other races as inferior.
I supported the Civil Registration Act 2004. It should have been introduced earlier and it gave same-sex couples the same rights under the law and the tax system that I enjoy as a married person. I do not regard a couple’s civil partnership as inferior or unequal to my marriage; it is simply different. That Act was an end in itself; it achieved equality. I reread the debate and found no accusations against supporters of civil partnerships at the time that we were bigoted or homophobic because we were not legalising gay marriage and going all the way. What has happened between 2004 and now to make this Bill so urgent and pressing that it takes priority despite no manifesto commitment by any party, no coalition agreement, no Green Paper, no White Paper and no general campaign saying that we desperately need it?
As always, I am listening carefully to my hon. Friend. In so much as the Bill is an answer to any question, it may be an attempt to meet the perception that civil partnerships are somehow not enough. Given his argument, does my hon. Friend agree that the progressive outcome from what has so far been a hugely divisive process would be to meet that perception without redefining marriage and mortally offending so many of my—and I am sure his—constituents?
My hon. Friend makes a good point, which returns to a point raised earlier. This should be about equal respect. The real problem is not a lack of equality under the law but people’s perceptions of a lack of equality for those with different sexual persuasions. We must redouble our efforts to root out that lack of equality, but changing the nature and the word of a ceremony will not do it and we completely mislead ourselves if we think that it will.
Why are we here? Why has the Bill received such priority despite not having been in manifestos when there are other bigger priorities and inequalities? Why is it that women cannot become Members of the upper House because they cannot inherit a title? That is a big inequality. Why are we not putting through a law on the bigger inequality of forced marriage? Why has the Bill taken priority? The answer is because this is bad politics.
There are many reasons for opposing this Bill, only some of which are religious. Many of those reasons are secular. Atheist, I think, have a duty to protect the rights of those who, through many different deeply held faiths, will take a different view of this form of marriage. Many of the reasons not to support the Bill are based on poor, rushed drafting with a whole raft of “What nexts?” How much more will marriage be redefined? Many of those fears may turn out to be hollow, but on such a fundamental rewriting of an historical truth that has held that marriage is the union of one man and one woman, we are entitled to more security than quickly cobbled together, fangled quadruple locks that lawyers are already queuing up to unpick. Who are we, this Government of this country, to redefine the term marriage that has meant one man and one woman across cultures, ages, geographical boundaries since before state and religion themselves?
I do not claim that my church marriage is superior to another Member’s civil partnership. It is not; it is equal in the eyes of the law and society, just different. Let us get away from the basis that we need things to be the same to be equal. It is not the same thing.