Hospice Funding

Steve Double Excerpts

Monday 22nd April 2024 Commons Chamber

[Steve Double (St Austell and Newquay) (Con)]

Thank you, Madam Deputy Speaker—it is becoming a bit of a habit for me to be the warm-up act for the wind-ups, although I gather I will not get that honour this evening. It is a great privilege to speak in this debate, with heartfelt contributions from across the House, and I congratulate my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) on securing it.

Most of us hope we never need to experience hospices at first hand, but when we do experience them because a loved one needs their care and support, we realise how important and valuable they are. I am incredibly proud and privileged to have two exceptional hospices in my constituency. Mount Edgcumbe hospice, which is part of Cornwall Hospice Care, was opened in 1980 and was Cornwall’s first hospice. It has recently been rated as outstanding by the Care Quality Commission, which highlighted the caring and personal nature of the service provided by the staff, who are responsive to the needs of the patients. I did not need the CQC to tell me that. Indeed, my family and I know that first hand, because back in 2007 my mother died from cancer at Mount Edgcumbe hospice. She lost her second battle with breast cancer, and the care and support that we received as a family was outstanding. I place on record my huge thanks to them.

I am also greatly privileged to have Little Harbour, which is part of Children’s Hospice South West in my constituency. It opened in 2011, and its state-of-the-art facilities are some of the very best in any children’s hospice in the country. Having visited a number of times, I can testify that the atmosphere there is truly amazing, and one cannot help but be moved by the place. It supports children and young people up to the age of 21, including the youngest babies who need its care. The CQC praised the staff for their personalised care and support. That reinforces the important point that it is not just about the bricks and mortar or equipment that the hospices provide; it is the staff and volunteers who work there who make our hospices the amazing places they are.

We are lucky in mid-Cornwall to have those two excellent examples out of some 200 hospices across the country. Both are supported by amazing people—volunteers, fundraisers and donors—who play such an important part in ensuring that those hospices can continue. It is not just about the care that the hospices provide to the people who are sick; we have heard many times in the Chamber today about the wraparound care that hospices provide to families and friends, which is so important and valuable.

[Caroline Ansell (Eastbourne) (Con)]

My hon. Friend is making a moving and powerful speech, and he makes me recall my experience at Chestnut Tree House, which provides hospice care for children across Sussex. It is striving hard to meet all the demands on services. One group that we have not mentioned is those who the hospice may yet reach. It knows that many more families would benefit from its care, and it is working hard on that. Has my hon. Friend also found that in his constituency?

[Steve Double]

I am grateful to my hon. Friend for that intervention; she makes precisely the point that I was coming to. It is clear that there will be a growing need for hospice care in our country. We feel that incredibly acutely in Cornwall; our elderly population has grown by more than 50% in the past 10 years. Cornwall is at the point where almost one in four of our population is over 70 years old. That proportion will only grow in the years ahead, and it will simply mean that there is more demand for hospice care in our country. That is why it is so important that hospice care is properly funded.

I believe that it is best for our hospices to stay in the independent sector as charities. They gain most of their support from the public; I have seen that time and again for the two hospices in my constituency. Being independent from the NHS gives them a special place in our communities. People feel a great connection to them. They feel that they have a personal stake in the work that hospices do, particularly if they engage in fundraising for them. I fear that that would be lost if hospices were effectively nationalised. It is so important for our hospices that we continue that situation.

However, the Government need to better recognise the important role that hospices play. We have heard several times about the postcode lottery for NHS funding for our hospices. I tell the Minister that we need to address that. Cornwall Hospice Care, I am told, has the second lowest funding of any hospice charity in the country. Just 9% of its funding comes from the NHS, which means that 91% is raised through fundraising, donations and legacies. That cannot be right. I am all for donations playing a significant part in the funding of hospices, but the NHS should step up, particularly in Cornwall, and provide more funding to our hospices. We need to look at regional variation. Funding must be based on need for hospice facilities in each region. I urge the Minister and the Government to look at what more can be done to provide a level playing field on NHS contributions to our hospices.

We have all heard that the past few years have been difficult for our hospices, with the growing pressure of rising costs and demand. One thing we could do for the hospice sector is provide more certainty about funding through multi-year funding settlements, so that hospices can plan far better, and at least know what funding is coming from the NHS. With that certainty, they could plan accordingly.

In summing up, I place on record my huge thanks to those in every hospice in our country for the incredible work that they do—to the paid staff, the volunteers and the fundraisers. They work so hard, and are so generous in providing this vital service to our communities, particularly the two hospices in my constituency. There has been real consensus across the House this evening. Although we value and celebrate all the work that hospices do, more needs to be done to provide them with fairer funding, so that they can continue to play a vital role for our communities.

Tobacco and Vapes Bill

Steve Double Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Steve Double (St Austell and Newquay) (Con)]

I am not naturally inclined to want to ban things—I lean towards the Government intervening as little as possible and only when absolutely necessary—so I have thought long and hard about this Bill and whether to support it, and I have come to the conclusion that I will vote for it tonight.

The first reason for that is that although I have heard the arguments put forward by some today about freedom, the simple fact is that people who are addicted to nicotine and smoking are not free. I have seen many people suffering with the addiction through their life and trying to give up smoking, and any notion that somehow people who are addicted to smoking are free is nonsense. If we can ever help people to avoid becoming addicted to smoking and nicotine, the Government should take action. The Bill tries to address that issue in a sensible and pragmatic manner and in the right way.

I have also heard it said today that somehow smoking is a matter of personal choice and freedom and it does not really affect anyone else. I would challenge people who say that to go and talk to any family—we have heard stories about this in the Chamber today—who have lost loved ones through long and painful deaths as a result of their smoking. There are victims of smoking beyond the person directly involved, in their family.

Smoking also puts huge pressure on our health systems and damages our economy. These are prices we all have to pay for the addiction to smoking that so many struggle with. When I read the statistic that 75,000 GP appointments a week are directly as a result of smoking, I was astounded. I am sure that all of our inboxes are full of messages from constituents saying they are struggling to see their GP, so we can see that a great difference would be made if we freed up that capacity in primary care. For those reasons I think it is right on this occasion for the Government to intervene.

On the point about shop workers having to check the age of someone in their 30s or 40s to establish whether they are eligible to buy tobacco, the reality is that it will not happen because the whole point of the measures is to stop people smoking in the first place. We know most people start smoking when they are young, and by helping them to avoid ever starting when they are young we just will not have people in their 30s and 40s wanting to buy cigarettes. That is the point.

I also welcome the measures in the Bill on vaping. I have been incredibly concerned about the way vaping has taken hold of particularly young people in our country. I understand and acknowledge that it is a useful tool to help people to get off cigarettes by taking up vaping instead, but the reality is that it is now about so much more than that in our country. It is shameful how some of the vape manufacturers have deliberately tried to get young people addicted to vaping, so that they are locked into being their customers for the rest of their lives, just as the tobacco industry has done for too long. I therefore welcome the measures the Government are taking to try to make vaping less attractive to young people. I suggest that we need to go further. If we say that the main aim of vaping is to help people to get off smoking, why do we not also ban vapes for anyone born after 1 January 2009? If they will not ever smoke, they will not need vaping to get off smoking. That is one way we could go further to improve this Bill and prevent young people from ever taking up vaping in the first place. That would be incredibly welcome.

We do not know the long-term damage that vaping is doing to people. We are starting to see some of the evidence coming forward on the number of young people who end up in hospital as a result of vaping. I am deeply concerned that, just as with tobacco if it was being licensed today—with all that we know about the damage it does to people’s lives—we probably would not license it or approve it for sale. I am concerned that we do not yet understand the long-term impact of vaping, and it will reap a damaging effect on young people’s health.

The Bill is not perfect, but I acknowledge and respect the Prime Minister’s aims in coming forward with something that is bold and will address this important issue in our society. I am happy to support the Bill this evening.

Cass Review

Steve Double Excerpts

Monday 15th April 2024 Commons Chamber

[Victoria Atkins]

I am conscious that I have just answered that, but may I put on the record my thanks and respect for everything that the hon. and learned Lady has done in this field? She has at times had to walk a very, very lonely path, and I find it extraordinary that parliamentarians—who are elected to represent the best interests of our constituents, and indeed of our countries—would find themselves under that sort of pressure for simply stating biological fact. I hope that the hon. and learned Lady will be working with me to ensure that the recommendations in the Cass review are applied not just in England but in Scotland, in Wales and in Northern Ireland.

[Steve Double (St Austell and Newquay) (Con)]

I very much welcome this report and the strong statement by the Secretary of State in response to it. If there is one thing that should be above party politics, above political ideology, and above cultural trends or virtue signalling, it is the welfare of our young people, and this report lays bare that, sadly, that is exactly what has not been happening. This ideology has not only captured part of our NHS; it is found in many of our public sector institutions. I ask the Secretary of State, who has clearly taken a strong leadership position on the matter today, whether she will ensure that the findings of this report are implemented across Government—in education, local government, social services, and in our police force—to ensure that this can never happen again?

[Victoria Atkins]

This report sets out the evidence, which was not there before. It has taken four long years of very hard work to gather that evidence, and I hope and expect that the health sector will implement these recommendations. I also hope we can have a conversation about our wider public space, and I was very pleased to read the article by my right hon. Friend the Minister for Women and Equalities over the weekend. We have to de-politicise the public space and ensure that this evidence is applied across the board for the health of all our constituents and our country.

Pharmacy First

Steve Double Excerpts

Wednesday 31st January 2024 Commons Chamber

[Dame Andrea Leadsom]

As I say, more than 95% of all community pharmacies have signed up to the service, and all their pharmacists have been trained in how to deliver it.

[Steve Double (St Austell and Newquay) (Con)]

As someone who has championed the role of community pharmacies throughout my time in this House, I warmly welcome today’s statement. I am particularly delighted that we were able to host one of the pilot schemes in Cornwall, which was hugely successful, resulting in 7,500 consultations that took 6,000 appointments away from GPs and 75 A&E appearances. Will the Minister join me in thanking all the pharmacies in Cornwall that took part in that pilot, which was so successful?

[Dame Andrea Leadsom]

Absolutely. It is only by trying these things that we can see how successful they can be, and I do believe this service is going to radically improve patient access to care.

NHS Winter Update

Steve Double Excerpts

Monday 8th January 2024 Commons Chamber

[Victoria Atkins]

The figure that the BMA relies on is in fact from 2008, when the Labour party was in government for the first two years. The BMA cites a 35% pay rise. Just to clarify, independent organisations such as Full Fact and the Institute for Government rely on the consumer prices index measure, which shows a difference of 11% to 16%. I am sure that the hon. Gentleman will take into account the fact that we have already given graduate doctors, in their first year out of medical school, a rise of 10.3%, and I was willing to negotiate further and consider additional settlements that are fair and reasonable to the taxpayer.

[Steve Double (St Austell and Newquay) (Con)]

Is the Health Secretary aware that the impact of these strikes on the Royal Cornwall Hospitals NHS Trust has seen more than 7,000 appointments and operations cancelled and several million pounds in extra costs to the trust—and that is before the most recent strikes. Does she share my concern that the junior doctors are pursuing an unreasonable pay demand and causing lasting damage to patients and the finances of the NHS?

[Victoria Atkins]

My hon. Friend is a brilliant advocate on the challenges facing his rural and coastal community. We all know that geography is a factor in the difficulties of delivering healthcare in his corner of England, but everything the trust and clinicians do is about trying to improve healthcare for his constituents. I cannot be the only one who felt uncomfortable at the image of some on the picket lines last week singing while our constituents were struggling with cancelled appointments and worried about urgent and emergency care times. I am very keen that we should reach fair and reasonable settlements with junior doctors, but in order for that to happen they must act reasonably, change their minds and call off the strikes.

Oral Answers to Questions

Steve Double Excerpts

Tuesday 5th December 2023 Commons Chamber

[Dame Andrea Leadsom]

I am incredibly sympathetic to the hon. Lady’s constituents. The issue of RAAC is one that the Government are determined to resolve. There has been a £698 million programme of new funding to eradicate RAAC from the healthcare system, and that work is under way. She will appreciate that it is for integrated care boards to ensure that the provision is there for all patients but, if she should need help with contacting or negotiating with her ICB, I will be delighted to help her.

[Steve Double (St Austell and Newquay) (Con)]

A recent report highlighted the fact that in September there were 15,000 missed GP appointments in Cornwall. That is 15,000 appointments that could have gone to people desperately waiting to see their GP. It is happening month after month. Does the Minister agree that that is completely unacceptable, and can she highlight what steps the Government will take to address the issue?

[Dame Andrea Leadsom]

My hon. Friend is right; it is appalling that people book an appointment and then do not show up. In many GP surgeries now they post the numbers of patients who do not turn up for their appointments and urge people to make the effort to cancel. As part of our access to primary care, we are creating digital tools so that GP surgeries can notify patients that they have an upcoming appointment and say, “If you don’t need it, press here and it will cancel the appointment.” Measures such as that make it easier for people to cancel, but he is quite right that it is incumbent on us all, if we book that appointment, to turn up for it.

Edenfield Centre: Treatment of Patients

Steve Double Excerpts

Thursday 13th October 2022 Commons Chamber

[Will Quince]

The hon. Lady is right. I believe what I saw to be disgusting too. She specifically referenced those with learning disabilities and autistic people in long-term segregation. NHS England is undertaking independently chaired care education and treatment reviews for everyone with a learning disability and all autistic people in long-term segregation in mental health in-patient hospitals. A senior intervenor pilot is also underway. These actions will help support people in long-term segregation to move to a less restrictive setting or to leave hospital. A programme of safety and wellbeing reviews for the care and safety of people with learning disabilities and autistic people is now complete, and NHS England will be publishing the findings of a national thematic review later this year.

[Steve Double (St Austell and Newquay) (Con)]

Recruiting the right staff is key to providing the right mental health support. I know from conversations I have had with providers in Cornwall that they are facing a huge challenge in recruiting staff. Will the Minister lay out what steps the Government are taking to attract more of the right people to work in mental health provision?

[Will Quince]

I thank my hon. Friend for his question. We know this issue is not exclusive to mental health practitioners, and it can be a particular challenge in rural, remote and coastal areas. The Secretary of State is currently working on a workforce plan, which we hope to publish in due course. Talking more broadly about those working in mental health in the NHS, as raised by the hon. Member for Tooting (Dr Allin-Khan), we have 6,900 more mental health professionals in the workforce than in 2021, which is a 5.4% increase since then and a 12.2% increase on June 2010.

Oral Answers to Questions

Steve Double Excerpts

Tuesday 5th May 2020 Commons Chamber

[Gavin Williamson]

I certainly will join my right hon. Friend in paying tribute to the teachers and all those who work in schools not only in Harlow but right throughout the country for the amazing work that they are currently undertaking.

We are working closely on how we ensure that every child in this country has the ability to catch up, and I was interested to hear my right hon. Friend’s ideas. We are looking into how we can take forward some of those concepts, including the enormous good will among the British public, to help to support children to make sure that they do not miss out as a result of this crisis. We need to make sure that that is not just an idea but actually becomes a reality.

[Steve Double (St Austell and Newquay) (Con)]

What assessment he has made of the potential effect of the introduction of T-levels on the (a) quality and (b) recognition of technical education.

[The Parliamentary Under-Secretary of State for Education (Gillian Keegan)]

T-levels are based on the best international examples of technical education and, crucially, they are employer designed. They will help to raise the quality and prestige of technical education across the UK, with longer teaching hours and a meaningful industry placement. I am confident that they will provide a high-quality alternative to A-levels, giving technical education the status and recognition that it deserves.

[Steve Double [V]]

I thank the Minister for that answer. It is clear that T-levels will have a valuable part to play in ensuring that we have the workforce of the future across the economy, but the sector of the economy that is being most adversely affected by the current crisis is hospitality, and it is vital that that sector is able to access the workforce that it will need to recover, particularly in a post-Brexit world, so will the Minister please consider bringing forward a T-level in hospitality as soon as possible?

[Gillian Keegan]

I agree with my hon. Friend: equipping people with the skills that they need is crucial to our economic recovery, particularly in St Austell and Newquay. To support tourism and hospitality, which are important to his constituency, we will offer T-levels in cultural heritage and visitor attractions, catering, and management and administration. I hope that, with my hon. Friend’s support, T-levels will be available soon so that young people in St Austell and Newquay can benefit from a high-quality technical education.[Official Report, 1 July 2020, Vol. 678, c. 2MC.]

NHS Funding Bill

Steve Double Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Jeremy Hunt]

I am well aware of the fantastic work done by Combat Stress, and I think it is important for it to receive the funds that it needs. However, when we look at the root cause of the problems in mental health funding, we see that on both sides of the Committee there is some culpability, and that on both sides it was completely unintentional. I hope that the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth), will forgive me if I start with the other side.

The truth is that when targets were introduced in the 2000s for A&E and elective care waiting times they were hugely effective, but they were introduced only for physical healthcare. As a result, during the austerity period when the budgets of clinical commissioning groups or primary care trusts were under pressure, money was sucked out of community and mental health services. That is at the heart of the problem that has bedevilled mental health care. The position changed in 2012, because a Labour amendment to the Bill that became the Health and Social Care Act 2012 instituted parity of esteem between mental and physical health. We were the first country in the world to do that.

As a Conservative, I am always deeply sceptical about legislating for principles, because I am not totally convinced that it ever changes anything, but that amendment did bring about a significant and very practical change, which I discovered myself as Health Secretary. No Health Secretary and no NHS chief executive ever wants to have to say publicly that the proportion of funding going to mental health has fallen on his or her watch, because that would be a direct contradiction of the principle of parity of esteem. That is why, since this became law, we have seen the proportion of funding of the entire NHS budget going into mental health either stabilised or starting to go up. That should put to rest some of the Opposition’s concerns about the risk of a decreasing proportion of NHS funding going into mental health, but it does not solve the problem.

The issue when it comes to mental health services for our constituencies is not about political will or funding; it is about capacity. We have an enormous number of ambitious plans on mental health. I unveiled one—in 2016, from memory—that said we would treat 1 million more people by 2020 and increase spending by several billion pounds. The mental health “Forward View” had some very ambitious plans, and we had the children and young people’s Green Paper. There are also targets to increase access to talking therapies, which are essential for people with anxiety and depression. But if we do not increase the capacity of the system to deliver these services, in the end we will miss the targets. For example, the children and young people’s Green Paper is an incredibly important programme, with a plan for every secondary school in the country to have a mental health lead among the teaching staff who would have some of the basic training that a GP would have to spot a mild mental health illness, anxiety or depression, or a severe one such as OCD or bipolar, and therefore know to refer it—[Interruption.] I am getting a look. I understand, and I will draw my comments to a close—

[Steve Double (St Austell and Newquay) (Con)]

No, you are meant to face the Chair.

[Jeremy Hunt]

Thank you. I am sorry—I am new to this Back-Bench stuff. Apologies for not facing the Chair. I will now do so more diligently.

The point I wanted to make, Dame Rosie, is simply that the children and young people’s Green Paper requires an increase in the children and young people’s work- force of—from my memory as Health Secretary—9,000 additional people. The CAMHS workforce is actually only 10,000, so the Green Paper alone requires a near doubling of the mental health workforce. Far be it from me to teach experienced Opposition Members how to scrutinise the Government or hold them to account, but if they really want to know whether we are going to deliver on those promises, looking at the workforce numbers in children and young people’s mental health in the CAMHS workforce is the way to understand whether we are going to be able to deliver those extra commitments.

Children and Mental Health Services

Steve Double Excerpts

Tuesday 16th July 2019 Westminster Hall

[Steve Double (St Austell and Newquay) (Con)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I congratulate my hon. Friend the Member for Burton (Andrew Griffiths) on securing this debate. I concur very much with all that he said in his opening speech.

Because we have only a small amount of time, I want to address one specific issue that has been brought to my attention. We all agree that we have a growing challenge with mental health conditions among young people across the country. It is right to acknowledge that the Government recognise that and are acting. We are grateful in Cornwall that, as I speak, a residential unit for children with mental health conditions is being built, after many years of not having a residential unit and our children having to be sent all over the country to be cared for. That unit will be open soon, which is very welcome.

I am particularly concerned about the amount of pressure we are putting on our schoolteachers when it comes to caring for children with mental health conditions. We are expecting more and more of teachers in that regard when it is not their role or responsibility. I am concerned about the impact that is having on our teachers.

I am also concerned about another aspect of education, which is authorised absence. I know that is not the Minister’s direct responsibility, but I hope she will take the remarks on board and feed them back to the Department for Education. Many parents are coming to me saying that they are struggling to get the school to support them as a family when they need to take their children out of school because of mental health concerns and conditions, including to attend appointments with CAMHS or other organisations.

In one case, the school was refusing to recognise absence from a particular child who was suffering from a mental health condition until that condition had been formally diagnosed by CAMHS. As we have heard today, it can take many months—I have heard it is up to 18 months—to get a diagnosis from CAMHS. The school was sending warning letters home to the parents about the amount of time the child was having away from school and threatening to take legal action against them. All that was doing was exacerbating the problem and putting more pressure, more stress and more distress on the family at an already difficult time.

Through the Minister, I appeal to the Department for Education that we need our teachers, and our headteachers in particular, to be more understanding and more compassionate. They are being driven by a heavy-handed approach from Ofsted in meeting attendance targets. It seems that those targets, above all else, are the most important thing for schools. No recognition or allowance is given for the real challenges many families face when they have a child who is suffering with mental health conditions and is therefore unable to attend school regularly. They are being put under huge pressure.

Many children are aware of what is going on, and I am concerned that they are encouraged to bury the issue and go to school because they do not want the pressure put on their parents, rather than opening up and getting the help and support they need. We need to ensure that schools work with parents and families when they have a child facing these issues. They should not add to the problems or the pressure that the family is under. I ask the Minister to take that on board. We can do better in getting schools to recognise the concerns and conditions that many families find themselves facing and in working with families, rather than exacerbating the problem.