Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 25th November 2025 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State, the birthday boy!

[Stuart Andrew (Daventry) (Con)]

Thank you, Mr Speaker. Can I ask the Secretary of State why he has not sorted out the strikes and disputes?

[Wes Streeting]

I wish the shadow Health Secretary a very happy birthday—21 again! It is good to see him here.

We continue to hold the door open to the British Medical Association. If it wants to engage constructively, we are ready and willing. What we will not do is be held to ransom. What we cannot afford to do is pay more than we already have. What we are able and willing to do is go further to improve their career progression and job prospects, and to work with them to rebuild the NHS, which the Conservative party broke.

[Mr Speaker]

Order. I have a lot of topical questions to get through.

[Stuart Andrew]

But, Mr Speaker:

“The power to stop these strikes is in the Government’s hands.”—[Official Report, 6 February 2023; Vol. 727, c. 660.]

“They need to sit down and negotiate to end the strikes, but Ministers are too busy briefing against each other.” Those are not my words, but the Secretary of State’s words when he was standing here on the Opposition side. He said it was so simple. The Secretary of State is embroiled in a leadership battle that is taking over the need to focus on averting walkouts, and the Employment Rights Bill reduces voting thresholds on strikes and scrapping minimum service levels. Does the Secretary of State accept that things are only going to get worse as a result of the Bill? And in his words, does he agree that patients have suffered enough?

[Wes Streeting]

I was very clear in opposition about the Government’s responsibility to sit down and negotiate, and that is exactly what I have been doing. It takes two to tango. As for the other trivial nonsense the right hon. Gentleman mentions, I have been very clear that I am a faithful. Of course, if he were a gameshow, he would be “Pointless”.

--- Later in debate ---

[Wes Streeting]

If I were the hon. Gentleman, I would be more worried about the situation close to home and the SNP’s abysmal record of failure: while waiting lists are falling in Labour-led England and Labour-led Wales, in SNP-led Scotland they are rising, despite the biggest funding settlement since devolution began. It is a record that should make him and his party blush.

[Stuart Andrew]

On a point of order, Mr Speaker. I know that you have been incensed by the unprecedented briefings we have seen by the Government in the run-up to the Budget. It beggars belief that, despite your clear statements on this issue, they have done it again today by announcing that the Chancellor will announce £300 million for NHS tech in her Budget tomorrow—not through a briefing to journalists but with an article on the gov.uk website. This happened just today, after a Minister stood at the Dispatch Box yesterday and said:

“I can assure the hon. Member, given the respect that the Government pay to this House and to their obligations in it, that if there is an important policy announcement to be made, it will be made to this House.”—[Official Report, 24 November 2025; Vol. 776, c. 32.]

Given that that was clearly not the case in this instance, despite your statements, can you advise us as to what we as Members of this House can do?

[Mr Speaker]

It is frustrating for me and all Back Benchers, because everything should be heard here in the Chamber first. The Budget should be sacrosanct; it should be heard only on Budget day. What I would say is that it makes a change for Budget speculation to at least come to the Chamber, as that is quite out of the ordinary at the moment.

I thank the right hon. Member for giving notice of his point of order. As I have said on a number of occasions in recent weeks, the Government’s own ministerial code states that major announcements should be made in the House in the first instance, not in the media. We had an urgent question yesterday on this issue. The Public Administration and Constitutional Affairs Committee has been conducting an inquiry into ministerial statements and the ministerial code. I look forward to seeing its report earlier rather than later. I would also point out that the country expects the Budget to come out on Budget day. It does nothing for the City and it does nothing for how people view this Chamber if it does not. We will leave it there.

Unpaid Carers: Inequalities

Stuart Andrew Excerpts

Thursday 20th November 2025 Westminster Hall

[Stuart Andrew (Daventry) (Con)]

It is a pleasure to serve under your chairmanship this afternoon, Ms Vaz. I am pleased to respond to this important debate on behalf of the Opposition, and I thank the hon. Member for Shipley (Anna Dixon) for securing it and for her long-standing leadership on carers’ rights.

I acknowledge the contributions made by hon. Members across the House this afternoon. They have spoken very openly about their personal experiences, which helps to bring alive this debate and these issues. I am conscious that the hon. Member for Bexleyheath and Crayford (Daniel Francis) talked about how much work he has to do before he even gets to work, which reflects what so many people across the country feel. As has just been said, unpaid carers are the backbone of our care system. They provide vital support to loved ones, often around the clock and with little recognition, and at great personal cost. This debate is therefore not just timely, but probably overdue.

Before entering Parliament, I spent over 15 years working mainly in palliative care, and much of that in children’s hospices—lastly at Martin House children’s hospice up in Yorkshire. I saw the extraordinary compassion, amazing resilience and sacrifice from unpaid carers every single day, whether from parents caring for their terminally ill children, many of whom had very complex needs, or relatives supporting someone at the end of their life—people managing both care and grief at the same time. I will always remember one parent saying they would consider it a good night’s sleep if they got up only eight times in the night to help their daughter, which gives an indication of how much work they do. As the hon. Member for Shipley said, so many carers end up giving up work because they have to provide that care. Sadly, so many relationships break down because of the pressures.

I now find myself having to care for my elderly father. I had to move him into my home, and I am now seeing at first hand the things people have to do. When I am here, I always worry, “Is he okay? Is there enough food and milk in the fridge?” I also watch every single move he makes. I once turned my back, for literally a minute, and he fell flat on his face. I realise that it was not my fault, but I cannot help but have those feelings of guilt.

I also pay tribute to the hon. Member for North East Fife (Wendy Chamberlain) for her amazing work on the Carer’s Leave Act. That really is important, and the cross-party support for it showed Parliament at its best. It is great that carer’s leave is now a day one right and that it can be taken flexibly, because that is what unpaid carers need. They need to be able to take that half-day, or full day, if they need it because, as we have heard, one in seven are juggling work and caring responsibilities. I thank the hon. Lady and my hon. Friend the Member for Gosport (Dame Caroline Dinenage), who I know would like to have been here today—she gave quite a bit of support during the Act’s passage—for encouraging the previous Government.

[Wendy Chamberlain]

I thank the right hon. Gentleman for his kind comments. Passing a private Member’s Bill is obviously more straightforward with Government support, which I had, so I am grateful to him and his colleagues.

[Stuart Andrew]

It just shows how, when Parliament works well, it works exceptionally well.

I want to repeat some of the comments that have been made. The Government have launched a review of the potential benefits of paid carer’s leave, with the conclusions coming at the end of the year, I believe. As others have said, that is welcome, but I am sure that carers would hope that there will be clarity and no delays.

I look forward to hearing the Minister’s response to some of the issues that have been raised in this debate, and to hearing whether the Government are genuinely open to acting on the review’s findings. A fair point has been made about the length of time that people have to contribute to that consultation, given the responsibilities that they have. We must ensure that the consultation is accessible. I was a critic of this when we were in government, but doing just online consultations means that those who are not digitally savvy can be excluded. It is important we make sure that is not happening.

As other hon. Members have said, the financial pressures on carers remain severe, with one in four unpaid carers living in poverty. The employment rate among carers is just 50%, compared with 75% across the general population, but with the right support an estimated half a million carers could return to work. That would not only strengthen their security but contribute to the economy, which is what we all want to see.

In fairness, it is not just the Government who have to act; there is a responsibility on employers, too. I saw in the hospices that some businesses took on our young adults despite their life-limiting conditions. The employers told us that what they got from those individuals was utterly amazing, and that they were really dedicated to their work.

The recent increase to the carer’s allowance earnings limit is a step in the right direction, for which I thank the Government. However, the Carers Trust has rightly called for a full review of carer’s allowance and the wider support system. I am keen to hear whether that is something the Government are considering.

I am also concerned that the level of respite support has been falling, and has dropped by 6% in local authorities in the last year alone. I am concerned about, and pay tribute to, the charities that offer so much respite support. I know, from my consultations with charities, that the rise in national insurance contributions has had an impact, and that they have had to reduce and scale back their staffing. That is a concern, and I hope we recognise the size of their contribution.

At the hospices at which I worked, it was not just about end-of-life care. Some of the most important care they provided was respite stays. Either the child came on their own so that the family might go on holiday, or the whole family came together, which gave them the opportunity to be a family again. The child who needed care was being looked after by the care team, which meant the parents could be parents again to the siblings, who often miss out in such situations.

[Jonathan Davies]

The shadow Minister is making a very powerful speech. He raises the issue of national insurance, and I know that change was very difficult in the last Budget, but it was to get over £20 billion into the NHS, which I hope will improve respite care. We saw huge cuts to local authorities under the last Government, and we are paying for that in different ways, including in Derbyshire. I hope we will be able to move beyond the national insurance thing and get better public services. Hopefully, we will even be able to reduce national insurance in the future, but it is right to contextualise that in the circumstances in which we find ourselves.

[Stuart Andrew]

This has been a really good debate so far, and I do not want to get into party politics, but the rise in national insurance contributions is having an impact on charities—it really is. The cost is about £1.4 billion. Charities have been a cornerstone of respite provision, and without them we would not have as many respite places as we need.

The other point I want to make is about the social care review. I went to those cross-party talks, and I was encouraged by the first meeting—it felt like all of us, representing our political parties, wanted the talks to succeed—but it is disappointing that we have not had another meeting since. I am concerned. Baroness Casey is an exceptional person. She has a huge amount to contribute, and she certainly left me with the impression that she is absolutely determined to find solutions to some of the issues in social care, but I am anxious that she has responsibilities for other issues, all of great enormity.

I hope the Minister can update us on when we might have another meeting. As the hon. Member for North Herefordshire (Dr Chowns) said, we do not have to be invited by Baroness Casey; we can be invited by the Secretary of State. I know that Baroness Casey is doing an enormous amount of work on this issue, but it is important that, politically, we try to find where we can agree. If we can introduce things earlier, that would be to the benefit of everybody in the country who needs care.

I say that because I want to be constructive in opposition. I recognise that some of these things are not easy to deliver. They are difficult issues, but they demand more than our sympathy—they demand action. I do not claim that we got everything right in government, but I am clear that carers need to know that we are all listening and are keen to respond and deliver when we can. Unpaid carers do not seek praise; they just want systems that they can rely on, policies that reflect their worth and services that offer real support.

Finally, this is not about just one Department—it is not just the Department of Health and Social Care. There are many other Departments. Having been a Minister, I know the structure of Government means that working cross-departmentally can sometimes be a challenge. Can the Minister update us on how that is going? I know it is a challenge, and I wish him well in any cross-departmental work that is happening.

Unpaid carers deserve fairness, support and action. I finish by saying to every single one of them: thank you for the amazing contribution you make every day, looking after others and being the backbone I mentioned at the beginning.

Draft Health and Care Act 2022 (Consequential Amendments) Regulations 2025

Stuart Andrew Excerpts

Wednesday 19th November 2025 General Committees

[Stuart Andrew (Daventry) (Con)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I am sure it will delight the Committee to know that I do not intend to detain us for too long. [Interruption.] I always get a cheer when I say that. I would like to begin by saying that I do not see anything particularly contentious in this. The Minister rightly points out that these are technical changes that bring the Down Syndrome Act into line with the reforms introduced by the Health and Care Act 2022, in particular the replacement of CCGs with ICBs and the renaming of the NHS Commissioning Board as NHS England.

However, it is worth questioning the Government on the longer-term stability of these changes. As hon. Members will know, the Government have stated their intention to abolish NHS England by April 2027. That process has already been delayed, reportedly due to uncertainty over who will meet the redundancy costs for staff within those organisations. If that abolishment proceeds, a new health Bill will be required. At present, we do not know when that Bill will be brought forward or what it will contain. It is therefore entirely possible that the statutory references being updated today will need to be amended again in the near future.

I also note that there is no statutory review clause in this instrument. While that may be understandable given the technical nature of the changes, it adds to concerns that further legislative changes may not be properly anticipated or subject to adequate scrutiny in good time.

While I support these draft regulations, I urge the Minister to clarify what transitional arrangements are being considered for the functions currently held by NHS England and the integrated care boards. That is especially important, as he rightly pointed out, for the consistency of support that we all want to see in the context of the Down Syndrome Act. We must ensure that people with Down’s syndrome are not adversely affected by any ongoing organisational changes within the health system. The Minister mentioned some of the updates to the Down Syndrome Act. Perhaps he could update us further on any other actions that are ongoing. How many still need to be done?

In addition, I note that the Act seems to require the Secretary of State to publish guidance, on which the Government have just launched a consultation. One of the criticisms of the Act at the time was that it is specific to Down’s syndrome. Although I obviously welcome that focus, others face similar disabilities and challenges. How might the Government support them?

Finally, it looks like people can respond to the guidance only online. Can the Minister assure the Committee that he is confident that those who are digitally excluded will not be prevented from taking part in this important consultation?

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 21st October 2025 Commons Chamber

[Mr Speaker]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

First, it is great to be in this new role. I genuinely want to be part of a constructive Opposition, but equally I want to do my role in holding this Government to account. I note the lack of detail in the Secretary of State’s answers on reorganisation, so can I ask the basics again? How many people will be made redundant, what will it cost and who is paying?

[Wes Streeting]

I welcome the shadow Secretary of State to his place. It is good to hear from the Conservative Front Benchers; I had almost forgotten they existed. The Conservatives created a complex web of bureaucracy. It is a bit rich to complain we are not abolishing their creation quickly enough. We have had a number of expressions of interest in voluntary redundancy across my Department, NHS England and the integrated care boards, and we are working through that as we speak.

[Stuart Andrew]

Again, the Secretary of State cannot answer. His answers are too vague. He is very good at making promises, but the facts are that he is presiding over a reorganisation that has stalled, creating uncertainty for staff. Waiting lists are up 50,000 in the past three months, hospices are in crisis because of national insurance contribution rises, and we have had strikes again—despite big pay rises—with the threat of more. If the Secretary of State wants the leadership in the future, perhaps he should show leadership in the NHS now, and tell us not just the plans, but when he will give the details and how he will deliver on his promises to patients.

[Wes Streeting]

Waiting lists are lower now than when Labour took office, and that is in stark contrast with the record of the Government in which the shadow Secretary of State served; waiting lists increased every single year they were in charge. This is the first year in 15 that waiting lists have fallen. That is the difference that a Labour Government make. We are only just getting started. As for leadership changes, we all know why they are calling the Leader of the Opposition “Kemi-Kaze”.

Points of Order

Stuart Andrew Excerpts

Tuesday 21st October 2025 Commons Chamber

[Mr Speaker]

First of all, you cannot continue the debate, but you have certainly put that on the record.

[Stuart Andrew (Daventry) (Con)]

On a point of order, Mr Speaker. Before beginning my questions, I meant to pay tribute to our former colleague Oliver Colvile, who sadly passed away last night. He served as the Member for Plymouth Sutton and Devonport between 2010 and 2017 and was named by Conservative Home as one of a minority of Conservative MPs not to have voted against the Government, which, as a previous Whip, I thought was exceptional. He was a true gentleman whose eccentricities endeared him to many. I am sure the thoughts of the whole House are with his family.

[Mr Speaker]

We all remember Oliver Colvile very fondly. He really was a good MP and a nice kind of guy to meet. I knew Oliver way before he came to this House. We are all saddened to hear the news.

Mental Health Bill [Lords]

Stuart Andrew Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

I want first to recognise and thank everyone for the constructive debates we have heard here and in the other place throughout the Bill’s passage. In particular, I thank the shadow Minister, my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), for everything he has done on the Bill, especially in Committee. I pay tribute to my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) for his expertise, whose involvement with the Bill began before he was elected to this place. I also pay tribute to my right hon. Friend the Member for Salisbury (John Glen) and my hon. Friend the Member for Farnham and Bordon (Gregory Stafford) for their thoughtful contributions.

This is clearly an important and emotive issue, and the respect and sensitivity that have been shown by all sides is a testament to this House. Since the election, we have said that we would not oppose for the sake of opposition. While we have rightly asked tough questions of the Government, we have done so with the best interests of patients at heart, because everybody here wants to help and support vulnerable people better—those patients with the most severe and complex mental health needs. This Bill, which started under the previous Government—I pay tribute to former Prime Minister Baroness May for that—and continued under this Government, will achieve that. We welcome efforts to improve the patient’s voice and involvement in their own care, to ensure that patients receive effective and appropriate treatments, to minimise restrictions on liberty so far as is consistent with patient and public safety, and to treat patients with dignity and respect.

Although we are disappointed that opportunities to strengthen the Bill further have been missed, especially in public safety and the protection of vulnerable children, we listened closely to what the Minister said and to his assurances on action, for which we thank him. We will of course continue to push on these matters, not on party political grounds, but because doing so is the right thing for patients.

We are very disappointed that the proportion of health spending on mental health has been reduced. We welcome the Government’s continuation of our work looking again at how we treat and protect people with the most severe mental health illnesses, so that we can improve the safety, treatment and dignity of patients and the wider public, and ensure that our laws remain relevant and proportionate in the modern world. The Government must now turn their words into action and deliver on the commitments that they have made.

I thank everybody again for the constructive way in which they have dealt with the Bill. We are pleased to support its Third Reading. We hope that it will bring improvements for those we all care about: the patients.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

Support for Life-shortening Conditions

Stuart Andrew Excerpts

Tuesday 7th June 2016 Westminster Hall

[Stuart Andrew (Pudsey) (Con)]

I beg to move,

That this House has considered support for children and young people with life-shortening conditions.

Mr Percy, may I say what a pleasure it is to serve under your chairmanship for the first time? [Hon. Members: “Hear, hear.”]

Prior to entering Parliament, I spent most of my working life in the hospice movement, with both adults and children. I worked in hospices, including Hope House in Oswestry; East Lancashire hospice, which cares for adults in the east Lancashire area; and Martin House children’s hospice, which cares for children in the Yorkshire area. During that time, I saw children and their families at their most vulnerable, looking for any kind of solace in what are probably the most challenging circumstances that any of us could possibly imagine.

In my 14 years working in the sector, I saw the hospice movement adapt and grow to meet the needs of children and young people as medical technology and provision developed. That growth was achieved by listening and putting the patients first at all times. However, unfortunately, there are still cases across the broader palliative care sector where that does not always happen, and that is why this debate is so important. There are currently 49,000 children and young people—and the number is rising—living in the UK with life-shortening conditions.

[Nick Thomas-Symonds (Torfaen) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Percy. I congratulate the hon. Member for Pudsey (Stuart Andrew) on securing such an important debate. He just quoted a statistic. Does he agree that data collection is one of the most important factors? Robust data collection is needed so that we do not underestimate the number of children who are suffering from life-shortening conditions.

[Stuart Andrew]

The hon. Gentleman makes an important point, which I will come to later.

Some 49,000 children and young people are living with conditions that are life shortening, by which we mean conditions for which there is no reasonable hope of a cure and from which most of those young people are expected to die. The conditions can include conditions for which curative treatment may be feasible but can fail, as is often the case with cancers or congenital heart diseases; conditions for which premature death is inevitable but where there may be prolonged periods during which the child is well, such as Duchenne muscular dystrophy; progressive conditions such as Batten disease, without any curative treatment; and irreversible, but non-progressive, conditions that cause severe disability, leading to susceptibility to health complications and premature death, such as severe brain injuries.

The number of young people affected by one of those four categories of condition is equivalent to one child in every single school, and 50% of the 5,000 children who die in the UK each year will have one of those conditions. Of course, the number of people affected in other ways is much higher. Parents, siblings and other family members and friends can bring the number close to 400,000 people, which equates to more people than the population of the city of Leicester.

The 49,000 children and young people need palliative care from the point at which their condition is diagnosed or recognised—often at birth—until the end of their lives. There is an entire package of outcomes that good palliative care should achieve, which is quite different from that which adults receive given that children often need care throughout their entire life. Good care should meet children’s physical, social and emotional needs, enhancing their quality of life to ensure that the child and their family can come to terms with such life-altering issues.

[David Simpson (Upper Bann) (DUP)]

I congratulate the hon. Gentleman on obtaining this important debate. I am sure that many people here will have come into contact with children with such difficulties. Does he agree—he touched on this point—that more psychological help is needed for the parents, especially when the children are approaching the time of death? It is a very difficult time. There need to be very quick results. Help is needed for the parents as well.

[Stuart Andrew]

I absolutely agree. During the time I spent in the hospice movement, I learnt that those final few weeks are incredibly distressing. None of us can possibly imagine what it is like unless we have been through it. The support for the parents and the wider family is what makes much of what happens in the children’s hospice movement such a success.

The care must be age appropriate—suitable for a child’s particular stage of development—and administered by people who have the exact skills needed to get the person through their care pathway. A comprehensive local children’s palliative care service spans health, social care and education. Joint commissioning is vital and should be accessible 24/7, 365 days a year, from diagnosis to bereavement. As a result of the complexity and severity of patients’ needs, the transition from children or youth services to adult services can be particularly daunting.

[Mr Robin Walker (Worcester) (Con)]

I am grateful to my hon. Friend for securing the debate and for the well-informed points he makes. Is it not the case that improvements in medical technology mean that more children with life-limiting conditions are transitioning into adulthood? Therefore, we have a real duty of care to ensure—as Acorns Children’s Hospice in my constituency is doing—that we find the best pathways to support those people into adulthood and to give them the best chance of living a quality life with the time that they have.

[Stuart Andrew]

My hon. Friend is right. I saw great advances throughout my time in the hospice movement. When I first joined Hope House, the life expectancy of the children who suffered from Duchenne muscular dystrophy was usually no longer than 18 or 19. By the time I had finished my career in the hospice movement, some were living into their late 20s and possible even their early 30s. Transition is incredibly important for them, because often the style of care provided is geared more towards the older generation than to young people.

Transition is incredibly important and centres such as Martin House, which I worked for, understand that. It built Whitby Lodge, a dedicated unit for teenagers and young people, which has state-of-the-art equipment designed to enable social interaction through things such as a mini nightclub—something that we all take for granted. As well as caring for children and young people in the hospices, members of the care team supported the family in their home. Even after a child has died, help is provided in the form of bereavement care for family members.

Transitioning to other services can sometimes present real difficulties. From dealing with new agencies and professionals, to transitioning to a completely different plan, the result can create quite severe gaps in service provision. The impact is, frankly, quite shocking, with 36% of families breaking down, 64% of mothers and 24% of fathers having to give up work entirely, and nearly 70% of siblings being bullied or feeling isolated at school.

All that can create a cocktail of problems that leads families into poverty. Therefore, at all times, it is vital that locally available, community-led children’s palliative care is at the heart of the service provision. These kinds of services are, thankfully, easier to find than they once were due to local offers and organisations such as Together for Short Lives, which provide directories of available services. That is just one example of how provision has changed since I began working in the hospice movement.

I will never forget seeing families, drained and exhausted, arriving straight from work or school on a Friday, the colour drained from their faces with no fight in them, dragging bulky equipment around in their car, when all they wanted to do was what we all like to do—go out for a simple meal on a Friday night. Great palliative care allows those families to have short respite breaks, the importance of which really cannot be overstated, because it provides support to everyone in the family. With the number of children and young people with life-shortening conditions increasing, it is becoming harder for the Government, the NHS and local councils to budget enough to meet those families’ needs, given that the number of people with such conditions is not being monitored, as the hon. Member for Torfaen (Nick Thomas-Symonds) mentioned. The complex care that such families need from multiple agencies and professionals is not joined up enough, and families have to fight with their last ounce of strength to get the services they need. I therefore ask my right hon. Friend the Minister what can be done to ensure that the number and needs of children and young people with life-shortening conditions are more accurately monitored.

Funding for voluntary sector providers of children’s palliative care is not being provided fairly or sustainably. It is limited to medical elements of care and does not include crucial non-clinical elements such as short breaks and bereavement support. Together for Short Lives expects to publish soon the results of a series of freedom of information requests it has made to clinical commissioning groups and local authorities. Those results will show the extent to which different elements of care are being commissioned, and I hope that colleagues from across the country will use those data to see how their own constituents’ care is performing.

Before that, I ask the Minister whether he can set long-term plans for funding children’s palliative care fairly, sustainably and in a way that reflects the growing demand for such services. Additionally, will he work with his colleagues to write to CCGs and local authorities to make it clear what their responsibilities are in commissioning palliative care? Local authorities have a duty to provide short breaks for disabled children. However, they are cutting funding for short breaks at a time when demand from seriously ill children is increasing. The Government and local authorities, of course, face a difficult situation in balancing budgets, and I fully understand the need for that to happen, but at the spending review the Government gave councils the ability to raise more money for adult social care through council tax. Children’s social care was left out and I struggle to understand why, so I would appreciate it if he expanded on that. Additionally, will he hold local authorities to greater account for the money they spend on short breaks for disabled children and ask them what action they are taking to secure access to such breaks?

As I have mentioned, without access to specialist adapted vehicles, which many families need and many of which I saw, families are unable to transport their seriously ill babies and young children to and from hospital. That often traps those babies and young children at home or in a hospital bed, preventing them from enjoying the things that we all take for granted. Children under three with life-shortening conditions are not currently eligible for the mobility component of disability living allowance, so will the Minister work with his colleagues in the Department for Work and Pensions to change the eligibility criteria so that nought to three-year-old children with life-shortening conditions, whose lives will end without heavy and bulky medical equipment, can have access to such important vehicles?

[Mr Gregory Campbell (East Londonderry) (DUP)]

Does the hon. Gentleman agree that that single gesture would do more to transform the lives of many families than all the recommendations and assurances that we all want to give those families?

[Stuart Andrew]

I certainly agree. As I mentioned earlier, it was staggering to see the smallest child come with so much equipment to keep them alive. Larger vehicles enable such families to do the things that every family likes to do, for example to go out for the day. The lack of such a vehicle often creates more isolation for the siblings I mentioned a moment ago.

[Mark Durkan (Foyle) (SDLP)]

Further to that point, does the hon. Gentleman agree that, given the sensitivity of the issue, as he has laid out so well, it is terrible that the basic message to those families who have a child with a life-shortening illness is that the reason they cannot get that support is that the child is not old enough? That is a perverse message for those families.

--- Later in debate ---

[Stuart Andrew]

I take that point entirely. In this debate I want the issue to be considered carefully, because it seems perverse for a child to be too young to get the support they really need.

Medical advances thankfully mean that more young people with life-shortening conditions are living into adulthood. That should of course be celebrated but, as I have said, the transition from children’s services to adult services can be daunting and is often not joined up. There is currently a distinct lack of age-appropriate and developmentally appropriate palliative care services to meet the growing demand, so again I ask the Minister whether he will look into providing seed funding to voluntary sector organisations so that they can set up age-appropriate services for young people transitioning from children’s services to adult services.

I end by paying tribute to all the organisations, including Together for Short Lives, and all the people who were involved with Children’s Hospice Week a couple of weeks ago. Those dedicated people are really quite superb. I could never have done my job at Martin House or at Hope House without their tremendous effort. Their reputation helped us to raise the money we needed, and we should all pay tribute to the tremendous work they do. I hope that today’s debate will mean that we can all work together so that things can change for those 49,000 children and young people who are battling with the most difficult issues that we could possibly imagine.

[Several hon. Members rose—]

--- Later in debate ---

[Antoinette Sandbach (Eddisbury) (Con)]

I am very grateful to my hon. Friend the Member for Pudsey (Stuart Andrew) for securing this debate, which, as Members know, is on an issue that I feel very strongly about. It was heartening to hear about the work of the Hope House hospice that serves my constituents, although it is based over the border in Shropshire, and about the work of Claire House, which is a very effective children’s hospice on the Wirral.

Other hon. Members have spoken powerfully about the transport issues and the transition issues, so I will concentrate on the families and the role that they play. It is particularly important to do so this week because it is Carers Week, and we know the vital role that parents play.

My hon. Friend made an important point about the 2% funding that was mentioned in the Chancellor’s Budget and the fact that that funding is limited to adult social care. There is no justifiable reason for that discrimination. It is clear that local councils have cut their funding for services, particularly for short breaks. The impact of that on families is devastating. Thirty-six per cent. of families with children who have life-limiting conditions experience family breakdown. Therefore, it is vital that the Minister recognises that cuts by local authorities to the funding for those short breaks lead to increased burdens on Government elsewhere and that it is short-sighted not to fund those short breaks, which give the families and the siblings the vital respite that is often needed to ensure that they stay together as a cohesive unit and get the break from some quite onerous caring responsibilities. I do not say that in a negative way. All the parents absolutely love their children and want to give them the best they can in the short lives they have, but they need that break and the time for themselves.

[Stuart Andrew]

I am grateful to my hon. Friend for making that important point and I would like to give an example. I always remember speaking to a father at the hospice who said that if he got up eight times in the night he considered that a good night’s sleep. Does that not highlight just how important it is that the families get the respite that they need?

[Antoinette Sandbach]

It is absolutely critical. I have experienced the situation in which, because of advances in medical science, the doctors cannot say whether someone will fall on one side or the other of the line of likely life expectancy—fewer or more than 25 years—and they do not qualify for support from the voluntary sector. Hospices play such an important role in supporting families and I give credit to the Government for funding children’s hospices, albeit not at the same level as adult hospice care.

There is, however, a cross-border issue, which Claire House neatly exemplifies. The hospice treats a number of Welsh patients—it will not turn children away—but it does not get funded for any of the treatment it gives to them. I urge the Minister to consider having National Institute for Health and Care Excellence clinical guidance that would apply nationally and help to iron out some of the wrinkles, perhaps taking some of the best practice in the devolved nations. We have heard powerful contributions about some of the efforts being made in Northern Ireland. There is some learning that can be gained from across the devolved nations, but guidelines would ensure that hospices were put on a sustainable footing.

On that point, I support the call for joint commissioning and ask the Minister to consider what happens after the death of a child. I am here partly in my capacity as the chair of the all-party group on baby loss, and the subject has been debated elsewhere. There is important counselling support that could be put in place before the loss of a child and, indeed, afterwards. Hope House, for example, has a dedicated counselling centre and I am delighted that recently—in fact, just this week— I got confirmation from the Treasury that the Alder Centre could apply for LIBOR funding. The centre provides vital bereavement support for families in the north-west and I very much hope that it puts in an application before August. That is a beacon of light perhaps in the north-west and in the debate.

Junior Doctors’ Contract Negotiations

Stuart Andrew Excerpts

Monday 8th February 2016 Commons Chamber

[Ben Gummer]

The hon. Lady is also an intelligent woman, so let me ask her this. If a trusted body, such as the BMA, tells its members that they will have a pay cut of 30% and an increase in hours, but that statement is incorrect, does it constitute a lie? That is the question I would put back to her.

[Stuart Andrew (Pudsey) (Con)]

A number of Members met representatives of the BMA in the House of Commons. We were disappointed that, despite continued questioning, they refused to go to the negotiating table, but thankfully they eventually did so, and made some progress. My constituents want a safe, seven-days-a week NHS. Is it not time to get back around the table, so that we can provide the service that NHS patients want?

[Ben Gummer]

It is, and that is why we need to move ahead in fairly short order. Ultimately, if staff contracts are not reformed across the service, those who will suffer most will be patients, and what will be most affected is the consistency of care that they receive at weekends.

Gay Conversion Therapies

Stuart Andrew Excerpts

Tuesday 3rd November 2015 Westminster Hall

[Mike Freer]

My hon. Friend makes a good point, given the evidence. I am about to quote the Royal College of Psychiatrists, which states that such therapies are damaging not only to the physical health, but to the mental health of individuals who have such therapies inflicted upon them.

[Stuart Andrew (Pudsey) (Con)]

I congratulate my hon. Friend on raising this important issue. Is he as disturbed as I am to see figures from the United States on people who have gone through conversion therapy showing that they are 8.9 times more likely to commit suicide, 5.9 times more likely to suffer depression and three times more likely to take illegal substances than their peers as a result of this frankly outdated and cruel method?

[Mike Freer]

My hon. Friend makes an extremely powerful point. I am not surprised to hear those figures.

Anyone who is conflicted and in need of support while coming to terms with their sexuality is experiencing some difficult feelings. If they are told that they can be cured—I am yet to find a case of the cure being proved successful—they then have to deal with those feelings as well.

Children’s Palliative Care

Stuart Andrew Excerpts

Tuesday 3rd March 2015 Westminster Hall

[Steve McCabe]

Yes, I agree. That is exactly the point. It is fantastic that so many children now survive for so much longer. That creates new demands and service needs that have to be considered. I should be grateful if the Minister said what work is being undertaken, both within Government and the NHS, to ensure that these transition issues are being considered in any new funding plans. I concur with the hon. Gentleman on that. The Care Quality Commission report, “From the pond into the sea: children’s transition to adult health services”—that is its title, I kid you not—also indicated that this focus is important.

We are moving towards the election, so it would help if the Minister clarified where we are with all these plans. As I have said, I acknowledge that the intention is to create a fair and sustainable framework, but we are now in March—the projected launch date for the introduction of the new non-mandatory currency is March—and as yet, unless I have missed something, we do not know the Government’s intention. What I would really like to know, and what I think the hospices would like to know, is what is going to happen with the hospice grant? Is the intention that it should continue during 2015-16 and beyond? I am sure that the Minister appreciates that not knowing is a real source of anxiety and a blow to any attempts at long-term planning.

Almost 96% of children’s hospice organisations are worried, according to the Together for Short Lives survey, that CCG funding will be less than their existing grant and harder to access. That grant covered about 13% of the care costs incurred by children’s hospices and existing clinical commissioning group funding represents about another 12%. Uncertainty over almost 25% of previously guaranteed funding is a difficult basis from which to operate.

I am sure the Minister knows that these bodies rely massively on public generosity and fund-raising efforts, but they also need some core guaranteed funding. If the grant ceases and is not matched by equal funding elsewhere, 89% of children’s hospice organisations could be forced to reduce their services. Areas at risk include short-break services for 60% of users.

[Stuart Andrew (Pudsey) (Con)]

As someone who has spent 14 years working for the children’s hospice movement as a fundraiser, I am completely aware of the point that the hon. Gentleman is making. Short breaks are incredibly important, because they are not only a break for the child, but for the whole family. Often people arrive on a Friday looking utterly exhausted. Just being able to have some normal family time until Monday is a great relief for them. Is that not the importance of these short breaks?

[Steve McCabe]

I do not think we can in any way overestimate the importance of short breaks to families and to children. Both need space at times, and the hon. Gentleman is absolutely right. The survey suggests that more than 60% of users could lose that service. There is also a risk of a 35% reduction in family support work, which is connected with short breaks and enables many families to keep going in stressful situations. There is also a risk of a 23% reduction in the amount of end-of-life care support provided.

Short breaks provide respite for carers and families and should be funded by local authorities and the NHS under their respective legal short-break duties. Despite being key providers of short breaks, a third of children’s hospices are not recognised by local authorities as being short-break providers. Some 42% of children’s hospice organisations receive no funding from local authorities. Page 56 of the palliative care funding review report states that

“pre-bereavement support is an absolutely essential part of palliative care and should be fully funded by the state.”

The review goes on to state, however, that far from being universal, only 65% to 70% of local authorities have open access services. Without the children’s hospice movement, there will be a gaping hole in end-of-life care.

I am not here to criticise the Government’s intentions, but the combination of the election and a new system with many unanswered questions risks significant funding problems. As organisations try to tighten their belts and take on new responsibilities, there is a danger that they will fall back on what they know or believe they know. It will not help the children or families of children with life-limiting conditions if clinical commissioning groups fall back on a narrow, clinical model that focuses on the child’s health needs as defined by doctors. The currency should not be used as a top-up for the acute sector providers, who can access other tariffs to fund care for children with life-limiting conditions.

Palliative care for children with a life-limiting or life-threatening condition is an active and total approach to care, from the point of recognition or diagnosis through the child’s life to death. It embraces emotional, social and spiritual elements and focuses on enhancing quality of life. It also supports the family and includes managing distressing symptoms, providing short breaks and care right through to the point of death and bereavement. That more holistic understanding of palliative care is reflected in national policy documents such as NHS England’s “Actions for End of Life Care: 2014-16” and the 2014 Care Quality Commission handbook. I welcome the interest that the Government have shown in an often neglected area, but we now need some clear messages, actions and signals to ensure that valuable work is not wasted and that an easily avoidable funding crisis is not allowed to develop. Local authorities under significant financial pressures are highly unlikely to fund what they might see as additional services unless required to do so. NHS England’s draft currency for children’s palliative care should be accompanied by clear guidance to local authorities on funding short breaks and bereavement care.

I would like the Minister to give an assurance that the structure is clear and that the intention is to have a three-source funding arrangement, with NHS England commissioning specialised children’s palliative care and utilising the experience of the children’s hospice movement, with CCGs commissioning general children’s palliative care using the new per-patient funding system and working closely with children’s hospices and with local authorities required to commission social elements of palliative care, such as short breaks, bereavement care and support for siblings and other family members, and seeing it as their duty to work with children’s hospices. It is vital that all three funding sources complement one another. If not, there is a risk that local authorities will regard those services included within per-patient funding as the entirety of palliative care and avoid playing their part. NHS England’s specialised care could fall prey to a narrow medical model and never leave the acute hospitals.

The Government need to provide some specific distinctions between specialised and general palliative care, so that one side is not tempted to avoid its responsibilities by relying on the funding of the other. We also need to know that NHS and local authorities are clear about their duties under the Children and Families Act 2014. It places a duty on them to jointly commission care for children and young people with special educational needs and disabilities up to the age of 25. I urge the Minister to provide what answers he can today to a valuable sector, which eagerly awaits his response.