NHS: Staffing Levels

Tracy Brabin Excerpts

Tuesday 11th December 2018 Westminster Hall

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

I beg to move,

That this House has considered staffing levels in the NHS.

It is an honour to serve under your chairmanship, Mr Hollobone. It is a pleasure to lead this debate and I thank hon. Members for being present. I know that many are eager to contribute, and the fact that they have taken the time to be here, during one of Parliament’s more eventful weeks, emphasises the strength of feeling in the House about staffing levels in the NHS. I also thank the many organisations that have contacted me, offered support and shared their research.

It is clear that the issue of staffing in the NHS is a great and growing concern to many. Indeed, the case of my local NHS trust inspired me to apply for this debate. Most of my constituents rely on the Mid Yorkshire Hospitals NHS Trust for a range of acute hospital-based and community services. The trust serves not just the people of Batley and Spen, but more than half a million people across Wakefield and North Kirklees.

[Paula Sherriff (Dewsbury) (Lab)]

I thank my hon. Friend and neighbour for securing this important debate. My constituents also use the Mid Yorkshire Hospitals NHS Trust. There are still several hundred nursing vacancies there, and that is having a significant impact on the delivery of patient care. Does she agree that the chaos of the current Brexit situation is not helping to recruit nurses, potentially from the European Union?

[Tracy Brabin]

I shall go on to discuss that in more detail, but my hon. Friend and neighbour is absolutely right. We have both been in meetings with the trust where that has proved to be of great concern to it.

[John Howell (Henley) (Con)]

On a similar subject, is the hon. Lady aware that Oxford University Hospitals agreed today to fund the cost of obtaining settled status for EU nationals who work there?

[Tracy Brabin]

That is something that we have discussed with our trust. The cost should not necessarily fall on the shoulders of the people we want to employ, so that seems like a good thing.

[Gloria De Piero (Ashfield) (Lab)]

For Sherwood Forest Hospitals trust, which covers King’s Mill Hospital in my constituency, the latest figures show 200 nursing vacancies and, since nursing bursaries were abolished, a 32% decline in those applying to do it. Is it not time to bring nursing bursaries back?

[Tracy Brabin]

I absolutely agree that training for this most lauded position should not be done at the cost of nurses themselves.

[Jim Shannon (Strangford) (DUP)]

Does the hon. Lady agree that we must have fewer medical quangos and more medical professionals in their white doctors’ coats seeing patients; less cleaning up of paper trails and more cleaning up in wards and A&Es; and funding that is targeted at frontline staffing and reasonable rates of pay?

[Tracy Brabin]

Certainly, funding and support should be given to frontline staffing. I will go on to talk about how I see that playing out.

The Mid Yorkshire trust is a major employer of about 8,000 members of staff who operate across three hospital sites: Pinderfields Hospital, Pontefract Hospital and Dewsbury and District Hospital, which is in my constituency. Like many trusts across the country, the trust is feeling the pressure on recruitment. In the most up-to-date figures, which were given to me directly by the trust this week, there is a 10% vacancy rate. That includes 95 full-time-equivalent posts for medical staff, 209 vacancies for full-time registered nurses, and vacancies for all other posts covered by the trust. The trust tells me that its key workforce challenge remains recruiting registered nurses and junior doctors in training. Those staff shortages lead to expensive cover being required— a bill that is ultimately paid by the taxpayer.

I am pleased that the trust has taken steps to mitigate against staffing shortages, including an extensive recruitment programme where vacancies across the trust are advertised and marketed widely. It has introduced a new associate nurse role in partnership with a local university, and expanded and increased the number of apprenticeship opportunities to offer different routes into careers in the NHS. It has held open theatre days to promote particularly difficult roles to recruit for, such as operating department practitioners. Finally, it has increased the number of nurses and doctors on the local temporary staff bank, which reduces its reliance on, and the cost of, commercial agency staff. I am sure that all hon. Members agree that that is all great.

Despite that work, problems remain. I must put on record my concern that staffing shortages can lead to problems for patients. The ambulatory emergency care unit at Dewsbury and District Hospital opened in 2015 to care for patients who needed a quick diagnosis and treatment, and who could be treated without the need for admission to a hospital bed. Since July, it has been closed because of staff shortages and it will remain closed for the foreseeable future. It had also been closed from the end of December last year to early March. Patients now face the lengthy and expensive trip to Pinderfields Hospital.

In the most recent inspection at Mid Yorks, the results of which were announced last week, the safety of services was deemed to require improvement, which will cause deep concern to my constituents. We are now told that the harsh funding climate for our NHS, which has existed since 2010, is coming to an end—austerity is over.

[Stephanie Peacock (Barnsley East) (Lab)]

As the daughter of a nurse, I congratulate my hon. Friend on securing this important debate. I know she is a proud member of the GMB, like me, so I declare an interest in highlighting its survey, which showed that 78% of NHS and ambulance workers are incredibly concerned about staffing levels. Does she agree with a nurse from Barnsley who said that we need more registered nurses and trained support staff, not untrained volunteers, who are sometimes being used?

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[Tracy Brabin]

My sister is also a nurse. When someone has a nurse in the family, they understand how hard they work. My hon. Friend must be psychic, because I am about to go on to that point.

When it comes to the recruitment and retention of NHS staff, it could not be further from the truth that austerity is over. The Royal College of Nursing did not mince its words when it said:

“The UK is experiencing a nursing workforce crisis”,

particularly in England. With one in three nurses due to retire within a decade, we are looking at a perfect storm of increasing vacancies across health and care.

[Paula Sherriff]

Does my hon. Friend share my concern that, as a direct result of staffing shortages at Dewsbury and District Hospital, the midwife-led birthing unit has had to be closed several times? September was a particularly bad month for closures. That has a traumatic effect on mums-to-be, who expect to give birth there but turn up and get sent elsewhere.

[Tracy Brabin]

Capacity, particularly in midwifery, is a massive issue, and midwife recruitment is also a problem. A mum who is about to have a baby wants to make sure that they are guaranteed a bed and a midwife who will be with them throughout the process, so of course that is a concern. There are almost 41,000 vacant nursing posts in the NHS and it is estimated that that number will grow to almost 48,000 by 2023—just five short years away.

[Tim Farron (Westmorland and Lonsdale) (LD)]

The hon. Lady is being generous. Does she agree that the problem with the recruitment and retention of staff also stretches to our mental health services? In Cumbria, three years ago, the Government promised a specialist one-to-one eating disorder service for young people, which has yet to be delivered. Does she agree that it is not good enough for the Government to make promises that they cannot deliver because they cannot recruit the staff?

[Tracy Brabin]

We are seeing increasing problems around recruitment and retention in mental health services, which I will go on to. We know that nurses are heroes of our health service and that they will always voice their concerns.

A survey conducted by the RCN in 2017 had some deeply worrying results. More than half of the nurses said that care was compromised on the last shift and more than 40% said that no action was taken when they raised concerns about staffing. If there was any doubt about the commitment of nurses, nine in 10 were not paid for extra unplanned time worked in the NHS. Unpaid time worked by nurses in the NHS saves the NHS hundreds of millions of pounds a year.

I am not just talking about nurses and the worryingly low levels of recruitment. The Royal College of Physicians informs me that in Yorkshire and Humber 36% of physician consultant posts advertised were not filled. Across the UK, a total of 45% of advertised consultant posts went unfilled, due to the lack of suitable applicants. The RCP believes that we need to double the medical school places to 15,000 a year to alleviate this problem in the long term and it is seriously hard to disagree with that assessment.

The RCP is also calling for investment in public health initiatives, which I am sure is another thing that we all agree on. The desperate need for more mental health staff is well reported. The consultant psychiatrist vacancy rate in the northern and Yorkshire region, which Batley and Spen falls under, is 11.7%, which is higher than the average consultant psychiatry vacancy rate in England. One in 10 consultant psychiatrist posts are vacant. Doctors specialising in mental health are uniquely placed to look at a person’s brain, body and psyche. Such specialists will only become more important, so I ask the Minister to update Members on his plans to meet the target of 570 junior doctors specialising in psychiatry by 2020-21 and to say what plans he has to ensure that all trainee doctors have experience of working in psychiatric settings?

The British Medical Association has provided information on the potential impact of Brexit on staffing levels in the NHS. Nearly 10% of doctors working in the UK are from the European economic area. Doctors, as well as many other professionals, make a massive contribution to our NHS. However, the BMA warns that many EEA doctors continue to feel unwelcome and uncertain about their future here. Given the uncertainty that we have seen in the past few days, I imagine that that feeling will not change any time soon. The results could be devastating, with more than a third of doctors from the EU considering moving away from our country. That is the last thing we need, as hospitals are already chronically understaffed, with more than one in four respondents to a BMA survey reporting that rota gaps are so serious and frequent that they cause significant problems for patient safety.

Alarmingly, some doctors feel bullied into taking on extra work. It is clear that something needs to change, particularly now we are in winter again. There are too few staff, who are too stretched, and trusts across the country are struggling to fill vacancies. However, in order to fix a problem, we need to know whose remit it is to provide a solution. Shockingly, there are no specific legal duties or responsibilities at UK Government level to ensure that health and social care providers have enough staff to provide safe and effective care to meet the needs of the population. Health Education England has some powers related to the higher education supply. In practice, however, those powers relate only to the funding for the 50% of their courses that nursing students spend on placements. Health Education England no longer commissions higher education university places, meaning that it is responsive to students signing up for nursing courses rather than proactively seeking them based on areas of need and workforce planning.

We know that the number of European workers in the NHS has fallen dramatically since the referendum. Mid Yorks recruited highly skilled workers from the Philippines, but delays to visa applications meant that 50% of them have now gone elsewhere and into other jobs. We need to do better than that.

The case is clear to me and to many others that we need a proactive and accountable power-holding body that makes robust assessments of population need, and uses that need to calculate the workforce requirements. No action has been taken to assess the level of population need for health and social care support now or in the future. Nobody has calculated how many nurses are needed to meet those needs safely and effectively. No workforce strategy is in place to set up the mechanism through which new registered nurses can be generated through a supply line.

Workforce plans are not consistently available and when they are they are based on affordability and finance, rather than on the expertise and skills mix of staff required to care for patients. Plans are limited in their ability to make effective change. Providers may identify a need for more nursing posts but then find themselves unable to fill them. Vacant posts stay vacant and gaps on the frontline are filled by more expensive bank and agency staff, and—as we heard from my hon. Friend the Member for Barnsley East (Stephanie Peacock)—by volunteers, or substituted lower-qualified staff. Patient care is left undone, with lengthening waiting lists.

That is the sad truth of where we are and when the Minister responds I would be grateful to know what plans are in place to enforce accountability for the NHS workforce. Simon Stevens has confirmed that the long-term plan for the NHS could not definitely deal with the NHS workforce and there are serious concerns that without investment a new plan will ultimately fail.

Six years on from the Health and Social Care Act 2012, it is still unclear which organisation is accountable for workforce strategy. Too often, no one is taking responsibility. Health Education England has been consulted, but it has failed to deliver a workforce strategy. Now is the time for leadership and action, and I look forward to hearing from the Minister.

[Several hon. Members rose—]

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[Tracy Brabin]

I thank colleagues from both sides of the House for their contributions, particularly those with frontline experience, and I thank the Minister for his measured response.

I have a couple of points. First, I am sure the Minister can feel the sense of urgency in this debate. Although I appreciate that long-term discussions are needed, we still do not have a date for when the long-term plan will be published or for the consultation on the Royal College of Nursing proposals. The Minister said it would be soon, but when will we have that?

[Stephen Hammond]

There is a commitment from the Government to produce the long-term plan before the end of the year, as the hon. Lady knows, and I have written to Dame Donna to request a meeting to discuss the RCN’s proposals.

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[Tracy Brabin]

That is very reassuring.

We hear from across the House that mental health is receiving such little support. People are hanging by a thread. Nurses are saying to their organisations and their MPs, “I am worried for the health and safety of my patients. I’m doing too many shifts. I’m absolutely shattered. I can’t guarantee that I am going to be doing my job properly. They’re bringing in volunteers to support me on the ward.” It is an absolute crisis. While I understand that the wheels of government work very slowly, I hope that the Minister takes from this debate that Brexit has been a universal issue. We are losing staff members. I welcome the commitment to an extra 5,000 doctors and so on, but that is just plugging the gap of the staff who are draining away from our hospitals and frontline services.

[Stephen Hammond]

I absolutely recognise that Brexit is a pressure on the system, but we should also recognise that there are 4,367 more professionals working in the NHS from the EU than there were at the date of the referendum. It is important to put that on the record.

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[Mr Philip Hollobone (in the Chair)]

Order. I call Tracy Brabin.

[Tracy Brabin]

If that is the case, the statistics are welcome, but in my constituency we are losing European members of staff. We cannot get away from the overall numbers—there are staffing shortages of 10%. In my constituency and in my trust they cannot recruit, because of various issues. I am grateful that the Government listened when I raised the question of tier 2 visas with the Prime Minister, when we wanted to bring over a paediatrician but could not because the visa took so long that he got another job. I welcome that when it comes to nurses, too, but we have to accept that there are things such as the bursary—

NHS Outsourcing and Privatisation

Tracy Brabin Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

I am pleased to be called to speak in this important debate.

In my constituency, local NHS services have been an issue of concern for some time. It seems that services are forever under threat and that our local trusts are always struggling. Dewsbury Hospital, which is in my constituency and serves my constituents, has seen a number of its functions move to Pinderfields Hospital. Its A&E has been downgraded, so that seriously ill patients are more likely to be taken elsewhere, and in recent weeks the Secretary of State for Health stepped in to prevent any potential closure of the A&E at Huddersfield Royal Infirmary. That was a welcome step, but our NHS services should not be in a position where such drastic changes to provision are suggested.

I, like so many colleagues in the House, am in awe of our hard-working NHS staff, and I know that, in the Mid Yorkshire Hospitals NHS Trust, they continue to go above and beyond in ever more testing conditions. I pay tribute to them, and also say to Ministers that in my constituency we want our NHS staff to remain NHS.

Just last week, the Mid Yorkshire Hospitals NHS Trust announced plans to move staff into a wholly owned subsidiary company—something that, as we have heard from my hon. Friend the Member for Blaydon (Liz Twist) and others, is part of a national roll-out. That subsidiary will run a considerable range of local NHS services and will be responsible for an enormous number of local staff. The announcement came with very little warning and no public engagement about the plans.

Once again, I reiterate that I appreciate and understand the pressures that are being put on NHS trusts by the Government, and Mid Yorkshire is no different; but for me, the decision to move to a wholly owned subsidiary company simply is not the right one. Opposition has already been growing. The trade union Unison has called the trust’s plans an “insult” to workers, and will be balloting its members next month over potential strike action—something that will leave my constituents concerned, but also frustrated, as this problem is avoidable. They will understand that to take people off NHS contracts, and thereby put them at the risk of a future where the terms and conditions of their employment are inferior to those of their colleagues, can only worsen the situation.

The good news is—I hope it is good news—that the decisions on whether the trust can go ahead with its proposals are not a done deal. The Secretary of State for Health and Social Care still has to approve the plans. I say to him and his colleagues that these staff, including cleaners, IT specialists, maintenance workers, help keep our hospitals safe and functioning. They have stuck by the NHS in extremely testing circumstances, throughout years of pay stagnation. I, staff and the unions know that it is not the right decision to go down this path—a path that could lead to a two-tier workforce, where two colleagues working side by side, doing the same hours, the same job, could end up taking home a different wage.

Let us do the right thing by NHS staff and local people, and consign this wholly owned subsidiary to the bin where it belongs.

Oral Answers to Questions

Tracy Brabin Excerpts

Tuesday 20th March 2018 Commons Chamber

[Mr Hunt]

I am pleased that the hon. Lady mentioned that, because today is world social worker day. It is a day on which to celebrate the brilliant work done by people working in the social care system, often at low rates of pay. We should also celebrate the fact that, thanks to the national living wage, 900,000 workers have benefited, including through a raise of up to £2,000 a year in the take-home pay for the lowest paid workers.

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

7. What steps he is taking to ensure that children have access to NHS dentists.

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

Children’s oral health is better than it has ever been, and 72% of five-year-olds in England are now decay free. Of course, that means that 28% are not, which is why our Starting Well programme aims to increase access for young children in 13 high-need areas. NHS England is also looking at making similar approaches available in the areas of greatest genuine local need.

[Tracy Brabin]

In Kirklees, 29% of under-five-year-olds have experience of tooth decay. Nationally, among five to nine-year-olds, tooth decay is the most common cause of hospital admission. Does the Minister agree that the system of penalising dentists for not hitting targets and not paying them when they exceed targets has led to a situation where there are virtually no NHS dentists available for my young constituents? What steps will he take to make more places available?

[Steve Brine]

We are testing the new prevention-focused dental contract, which the hon. Lady knows about, to improve access and outcomes for NHS dental treatment. We have also made great progress on children’s oral health, as I have said. NHS England in her area is currently finalising arrangements for extra funding to support dentists in offering additional access and places. That funding will be available from 1 April, so she and other Members should stand by their phones.

NHS Winter Crisis

Tracy Brabin Excerpts

Monday 5th February 2018 Commons Chamber

[Stephen Barclay]

I absolutely agree with my hon. Friend that the NHS will remain free at the point of delivery. The reality is that for the majority of the NHS’s existence, it has been run by the Conservative party. We know the value of retaining healthcare free at the point of delivery, and the Secretary of State has repeatedly reaffirmed his absolute commitment to that.

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

In my constituency surgery, two sisters came to speak to me about their father, who went to hospital last month. Because the staff were so overstretched, he was placed in the wrong ward, so he did not get seen by a doctor for four days. Will the Minister reassure the sisters, and will he will pause the downgrade of Huddersfield Royal Infirmary and rethink this so that the winter crisis does not become a daily crisis in the NHS?

[Stephen Barclay]

As the hon. Lady knows, local commissioning decisions are for the clinical commissioning group and local commissioners, but again, not one Opposition Member has recognised the additional funding that has gone in. Her own trust received an additional £3.4 million—[Interruption.] Well, it never is enough for the hon. Lady. The question is, how, with the economic mismanagement under their party, Labour Members are ever going to deliver what they want? Her trust received an additional £3.4 million to address the pressures.

Hospital Car Parking Charges

Tracy Brabin Excerpts

Thursday 1st February 2018 Commons Chamber

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

It is a pleasure to follow my hon. Friend the Member for Slough (Mr Dhesi), and I congratulate the right hon. Member for Harlow (Robert Halfon) on his extremely powerful speech and on raising this important issue.

I want to start with an experience that our family recently went through. My daughter started to show signs of acute appendicitis. As any family could imagine, we quickly bundled our daughter, who was in agony, into the car and drove to the hospital—it was not a very calm journey. I am sure that many Members will have had a similar experience. We were panicking and scrambling around for change so that we could park the car, then taking turns to pop out every few hours to move the car or top up the ticket. That was obviously a one-off and bearable, but for many a trip to the hospital is sadly not a one-off experience, and they are forced to take several trips a week because of chronic illness. They are people going through the worst of times, and the cynical approach of charging them to park is unacceptable. It is not anyone’s choice to be ill, and they should not be exploited.

New figures show that the money raked in from NHS car parks in England run by private firms has increased to £500,000 every day. The £175 million that was made from hospital car parking charges in 2016-17 is equivalent to only 0.001% of the total health spend, but still, ruthless private car parking firms pocket most of it. It cannot be fair that worried family members who visit their loved ones can end up with eye-watering fines if they arrive late back to their cars. As my hon. Friend the Member for Heywood and Middleton (Liz McInnes) said, it cannot be fair that NHS staff who have parking charges deducted from their wages are fined for parking in the wrong bay when they cannot find a space in the correct bay.

Some may recommend that regular hospital visitors use public transport, but in my constituency, Batley and Spen, the bus that used to connect Birstall with our local hospital has been cancelled, as have local bus services in many smaller communities. That has forced more people to use a car and thereby incur parking costs. My local hospital, Dewsbury and District Hospital, charges after 20 minutes, so people get 20 minutes for free. There is a reduction for blue badge holders, but they still have to pay. There is a stress-inducing pay-on-exit system, and it is quite complicated to get car parking concessions approved by hospital staff on the day. It is not an ideal situation.

[Sir Mike Penning]

Does the hon. Lady agree that in the 21st century, means-testing at the point of delivery, which is what we are talking about here, is morally unacceptable in an NHS of which we should be and are proud?

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[Tracy Brabin]

I am so glad that the right hon. Gentleman raised that issue, because the concession that I was talking about is available only to the patient, not to the low-paid person who may have driven the patient to hospital. The poorly person has to go and get the car parking concession. It is absolutely unfair.

A freedom of information request by Unison revealed that some hospitals charge nurses and health professionals who regularly visit hospitals up to £100 a month. As other Members have said, the cost of parking also has wider effects on the surrounding streets. I have been contacted by many constituents living around Dewsbury and District Hospital who complain that those who cannot afford car parking charges, or who think they might have to stay for several hours, park on residential streets, blocking people’s drives and making it difficult for people to park outside their own homes. Free hospital parking would end that.

We know that trusts are struggling to balance the books after years of being underfunded by the Government, but we must ensure that they are not forced to fill the funding gap by charging sick and poorly patients, their visitors and anxious relatives, and already hard-pressed NHS staff.

Car parking charges are a tax on serious illness. Labour would scrap car parking charges at all hospitals. We would fund that by raising insurance tax on private healthcare to 20%, to meet the £162 million cost of providing free parking at all NHS hospitals in England. Charities, trade unions, the British Medical Association, the Society for Acute Medicine and the public are all calling out for the Government to listen. In Scotland and Wales, car parking charges have been abolished in all but a handful of hospitals. We should show some humanity and do the same. I support the motion.

NHS Winter Crisis

Tracy Brabin Excerpts

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

That is absolutely our intention.

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

May I press the Minister a little bit further on the photographs, which were taken by a constituent of mine, of people sleeping on the floor? These poorly people had been waiting on chairs for hours and had not been given a bed or a trolley. What I did not hear in his response was an apology. Is it not now time for the Minister to apologise to those affected?

[Mr Dunne]

The hon. Lady will have heard last week the apology from the Secretary of State to patients having operations postponed, and I am absolutely prepared to apologise today to patients who are not able to be treated as quickly as we would all like them to be treated. There are seats available in most hospitals, where beds are not available. I cannot comment on what happened in her individual case, but I agree with her that it is not acceptable.

Social Care

Tracy Brabin Excerpts

Wednesday 25th October 2017 Commons Chamber

[Jackie Doyle-Price]

I could not put it better myself. Necessarily, the system will always focus more on those with the most need, but, as the hon. Lady says, we can get a lot more return from putting in good value for money measures that will support people to live independently and to be able to work. I am very keen to explore those areas.

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

rose—

[Jackie Doyle-Price]

I will take one more intervention, but I really do need to make progress.

[Tracy Brabin]

I thank the Minister for giving way. Can she give me some advice for my constituent—a mother with a daughter who is quite disabled with epilepsy? When the mother was retiring, she realised that she would lose her carer’s allowance as she went on to the state pension. When she rang HMRC and the Department to inquire, they said, “By your age, they are normally shoved into a home.” Can the Minister give me some advice on how I could support my constituent?

[Jackie Doyle-Price]

I am not very impressed by the tale that the hon. Lady describes, but I would like to look into it more directly and get back to her.

The Government have already invested an additional £2 billion to put social care on a more stable footing and alleviate short-term pressures across the health and care system. However, further long-term reform is required to ensure that we have a sustainable system for the future—one equipped to meet the challenges of the increasing numbers of people with care needs. To address these questions, the Government will work with partners—including those who use services, those who work to provide care, and all other agencies—to bring forward proposals for public consultation. The consultation will cover a wide range of options to encourage a very wide debate. It will set out options to improve the social care system and put it on a more secure financial footing, supporting people, families and communities to prepare for old age, and it will address issues related to the quality of care and variation in practice. It will include proposals on options for caps on overall care costs and means-tested floors. It is, however, a consultation, and the Government wish to approach the future of social care in the spirit of consensus. Our consultation is designed to encourage a grown-up conversation in order that society can rise to this challenge.

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[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

I am grateful for the opportunity to speak in this most important debate. I would like to thank my friends on the Opposition Front Benches for bringing the subject of social care to the House today. Social care must be treated as the national priority it rightfully is. It is a vital public service that allows people in every one of our constituencies to live their lives in the way they want. The system supports older people, those living with mental health issues and people with physical and learning disabilities. This should be the least that we owe people in our country, but instead there is simply not enough money in the system. The Local Government Association has said that social care services nationally are facing an annual £2.3 billion funding gap by 2020.

Of course, some areas are affected more than others, and funding pressure is being felt keenly in my constituency of Batley and Spen and in our local authority of Kirklees. As my hon. Friend the Member for Colne Valley (Thelma Walker) has said, a third of the entire local authority budget is spent on adult social care. This is a local authority that has had to effectively cut half its budget since 2010 and is the second worst funded metropolitan council in the country. Senior councillors have openly warned that they might need to stop cutting the grass or collecting the bins in order to meet their social care requirements laid out in the Care Act 2014. Of course it is completely right that social care takes priority over other public services, but I am sure Members will agree that councils should be in a position to provide more and better services to local people, rather than constantly cutting back.

Let us take the case of the father of a constituent of mine. He is currently in Dewsbury District Hospital, and he is ready to be discharged. He has had a stroke, and he also suffers from vascular dementia and a condition called sundowning, which means that his dementia symptoms become more severe in the evening. Because of a lack of funding, there is no specialist provision locally that can cope with his complex needs. This family are faced with the prospect of their relative having to go out of the area, even as far away as Sheffield, for care. We have to find a national solution to this national issue.

The Care Quality Commission’s report earlier this month laid out the reasons for action in black and white. Only 2% of social care services were rated as outstanding, with 41% requiring improvement. A quarter of services are failing on safety and there are nearly 4,000 fewer nursing home beds now than there were in March 2015. This is at a time when demand is rising. In England, 1.2 million people do not receive the social care they need, which is up 48% since 2010.

The search for the much needed solution has to begin with getting the funding right, because the system’s future depends on it. Clearly, one way of not getting the funding right was illustrated by what the governing party put forward at the general election. Its intention to implement a “dementia tax” without limits went down like a lead balloon in my constituency and plenty of others. We have to assume that that policy is off the table—I am sure that Ministers will be eager to confirm that today—but that does not mean that the Government can keep treading water. Social care is a vital public service, and having a hole of this magnitude at the heart of Government policy is irresponsible. We need action. Instead of writing to councils to threaten fines and the withdrawal of funding because of unmet targets on delayed transfers of care, let us have a plan to remedy the £6.3 billion-worth of cuts since 2010. The quality of care needs to be rising instead of falling. Social care is there for the elderly and the vulnerable, and the least we should expect is a decent system that works for everyone.

[Several hon. Members rose—]

Access to NHS Dentists

Tracy Brabin Excerpts

Tuesday 12th September 2017 Commons Chamber

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

Does my hon. Friend agree that it is deeply worrying that 29% of five-year-olds in Kirklees have decayed, missing or filled teeth, and that in March 2017 NHS Digital told us that one in three children in Kirklees have not seen an NHS dentist for the past 12 months?

[Judith Cummins]

I certainly do. I thank my hon. Friend for that intervention.

The physical damage is visible—it is easily understood—but just focusing on this physical damage would be to underestimate what we are facing in this country. Much of the damage is much less visible, as it is emotional, psychological and hidden beneath the surface, with a generation hobbled by insecurity and embarrassment. At a time when mental health parity receives the personal endorsement of the Prime Minister, I despair that so many, mainly young people, are facing emotional disorders for an entirely preventable reason.

It is difficult enough for adults left with irreparable damage, but when our children and young people are left embarrassed, deeply under-confident and self-conscious, the true scale of what is happening reveals itself.

NHS Shared Business Services

Tracy Brabin Excerpts

Tuesday 27th June 2017 Commons Chamber

[Mr Hunt]

Just to be clear, this is a different contract, as I know the hon. Lady understands. We have been working hard, and I know that the hon. Lady worked hard with my Department in the previous Parliament to try to get to the bottom of the problems with the Capita contract. My understanding is that the situation is improving, but I will happily look into the individual situation she mentioned.

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

The Secretary of State said that this takes time and, if I heard correctly, that a third of GPs have failed to respond. What steps is he taking to ensure that patient care is not being compromised by the extra admin burden on already overworked GPs?

[Mr Hunt]

We are paying GP surgeries for the extra admin time that this is taking. That is designed to ensure that, where necessary, they can buy in extra resources to deal with the extra admin. The hon. Lady is absolutely right that we have to ensure that GPs’ core work is not compromised by the issue.

Pandemrix Vaccine: Compensation

Tracy Brabin Excerpts

Wednesday 8th March 2017 Westminster Hall

[Joan Ryan (in the Chair)]

Before the next debate begins, I am pleased to say that, on International Women’s Day, we have a woman Member opening her first Westminster Hall debate and a woman Minister to respond, and of course I am in the Chair. On this day, I thought that was worth remarking on. I call Tracy Brabin to move the motion.

[Tracy Brabin (Batley and Spen) (Lab)]

I beg to move,

That this House has considered compensation and the Pandemrix vaccine.

It is a pleasure to serve under your chairmanship, Ms Ryan, on the occasion of my first Westminster Hall debate. I thank my hon. Friend the Member for Liverpool, West Derby (Stephen Twigg) for his extensive work on this issue on behalf of his constituent Lucas Carleton. I also thank Mr Speaker for allowing this debate to take place. It is vital that Parliament considers this matter and public awareness is raised.

I will set out the effect that Pandemrix has had on several predominantly child patients and their families and discuss the need for the Government to acknowledge and express regret for what has happened to those patients and provide them with support. I will explain the challenges of accessing the necessary medication for affected people, and I will conclude by making recommendations to the Government.

Before I set out the issue at hand, I wish to be clear that, overwhelmingly, vaccines save lives. Thanks to vaccines, we have seen the eradication and near-eradication of diseases such as smallpox and polio, and I have no intention of discouraging parents from ensuring that their children receive tried and tested vaccinations. Quite the opposite—I want the Government to rebuild and maintain trust in our world-class inoculation programme. However, on occasion, certain vaccines have been shown to have damaged patients, sometimes with life-altering consequences. All precautions should be taken to prevent that from happening, and pharmaceutical companies and the Governments that give those companies indemnity should take immediate and full responsibility when that is shown to have happened and, having accepted responsibility, do all they can to support affected people.

I worked to secure this debate because I believe that Parliament and the Government must listen to and support individuals and families who have been affected by narcolepsy and cataplexy as a result of the Pandemrix vaccine. I became aware of this issue when my constituent Di Forbes came to one of my regular advice surgeries. Di has travelled to Parliament to watch these proceedings, and I hope that she will be able to travel home to Batley and Spen having received some assurances from the Government. Di explained to me the damage that the Pandemrix vaccine has caused her son Sam and the unacceptable battle that she has faced while seeking financial support to secure his long-term care and the appropriate medication for his condition.

By way of background, the Pandemrix vaccine was developed by GlaxoSmithKline and given to 6 million people during the global H1N1—swine flu—pandemic in 2009 and 2010. Owing to the nature of that pandemic, the European Commission, on the advice of the European Medicines Agency, fast-tracked the vaccine’s licensing. The UK Government then undertook a vaccination programme, based on advice from the Joint Committee on Vaccination and Immunisation. In short, Pandemrix was licensed for use in the EU, including the UK, without the usual clinical trials having been completed.

[Julian Sturdy (York Outer) (Con)]

I congratulate the hon. Lady on securing this important debate. My constituent Ben Foy suffers from narcolepsy and cataplexy caused by the Pandemrix vaccine. I raised his case in the House in 2014, 2015 and 2016, and I now do so in 2017. The Department for Work and Pensions accepts the causal link between my constituent’s illness and the Pandemrix vaccine that he received, on NHS advice, in 2010. Does she agree that the Government have a moral obligation to quickly resolve the issue of payments to those who have been so badly affected by Pandemrix, not drag the process out with unsuccessful appeal after unsuccessful appeal, which is what seems to be happening at the moment?

[Tracy Brabin]

I will come on to that point, but I totally and utterly agree. As the hon. Gentleman will know, the Government’s foot-dragging is causing unacceptable and upsetting suffering and distress for the families involved.

Although I acknowledge the difficult balancing act involved in weighing the risk of a pandemic against the risk of fast-tracking a vaccine’s licensing, that does not excuse the fact that some patients were not made aware of the facts, nor does it excuse the Government from subsequently attempting to avoid responsibility for the damage caused. Making the vaccine available at the time of the pandemic clearly came with a degree of risk. GSK was given an indemnity from any liability by the UK Government. My constituent has made it clear to me that she was not informed that the vaccine had not been fully tested or that GSK had obtained an indemnity. Therefore, as the result of advice given to his mother by the NHS, my young constituent Sam received the vaccine on 27 April 2010. He was four and a half years old.

Four months later, concerns were raised in Finland and Sweden about the association between the vaccine and narcolepsy. Following that, a study by the UK Health Protection Agency and others, which was funded by the Department of Health and the HPA, found that around one in every 52,000 to 52,750 Pandemrix jabs led to narcolepsy. The results of that study were published in The BMJ in 2013 and were consistent with the findings of the aforementioned Finnish and Swedish studies. Pandemrix stopped being given to children in the UK in 2011, but that was too late for Sam and dozens of children like him.

Sam has been affected by 14 severe or chronic neurological issues, including narcolepsy and cataplexy. He suffers from night terrors in which he can see and smell dead people. He suffers from a damaged heat regulation system, automatic behaviour, micro-sleeps, temper issues, joint and muscle pain, anxiety and depression. Sam is now 11 years old and has faced unimaginable strain. In addition to being prohibited from enjoying a normal childhood, he lives in a world in which most people know little about his condition and misunderstand his symptoms. Shockingly, on one occasion while Sam was passed out in the street as a result of his condition, a dog walker allowed her dog to urinate on him. No 11-year-old should be expected to face the indignity and pressures that children such as Sam live with as a result of the Pandemrix vaccine.

Tragically, Sam has tried to commit suicide several times. We know from a coroner’s report that one 23-year-old woman took her own life after telling her family that living with narcolepsy after receiving Pandemrix had become unbearable. This is all too desperately sad.

The link between Pandemrix and narcolepsy has had a profound effect on families. My young constituent’s parents have found themselves under immense pressure, and in October 2016 his mum Di had no choice but to call a liquidator into her engineering business. It was impossible for her to work and ensure that her son’s complex care needs were met. Life is unacceptably hard for Di and Sam. They are very grateful to Narcolepsy UK, which receives no assistance from the Government but has been a source of huge support for them.

The Vaccine Damage Payments Act 1979 was intended to help to ease the burden on individuals for whom a specified vaccine had caused severe and permanent disability.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on bringing forward this important case. The Court of Appeal has ruled very clearly on this matter and issued a telling judgment that opens the door to people who have suffered as a result of this so-called vaccine. I believe that its decision enables those people to get the compensation that they need, both physically and morally. Does she feel that the Government must now follow suit and give the go-ahead for compensation to be released?

[Tracy Brabin]

The hon. Gentleman is right. There have been some one-off payments, but they need to be made across the board. The 1979 Act provides for affected patients to receive one-off tax-free payments of £120,000, which would go some way to securing their long-term care needs.

Prior to September 2013, the Government said there was insufficient evidence to establish a causal link between the Pandemrix vaccination and the development of narcolepsy. However, following the aforementioned study commissioned by the Department of Health that recognised the link between Pandemrix and narcolepsy, the Government have conceded and recognised the link.

In spite of the Government’s acceptance of the link between Pandemrix and narcolepsy, they have delayed the processing of applications by denying them, disputing the severity of the disability. They have even appealed a case in which they were ordered to make a payment to one such affected child. In my view, for the Government to make such appeals through the courts system is a poor use of public money and an insult to those families whose lives have already been turned upside down. I hope that the Minister will disclose how much public money has been spent in the courts to delay making payments to those affected by Pandemrix.

Sam’s parents made an application for a vaccine damage payment, which was unsuccessful on the basis that he is not severely disabled enough. For those vaccinated after 31 August 2010, the reason given for refusal is that the vaccine does not fall within the remit of the Act. All appeals against the decision to decline payments are being held up while the Government battle the family of the aforementioned child through the courts. Most recently, the decision for the child to be awarded the payment was upheld at the Court of Appeal. I sincerely hope that the Government will accept that outcome and take the case no further.

To give some context to the UK Government’s position, Sweden, Finland, Norway, Iceland and France have already compensated those who developed narcolepsy as a result of the Pandemrix vaccine. Sam is in receipt of disability living allowance, meaning that the Government recognise he is disabled. Why, therefore, do they not consider him to be disabled enough to qualify for a payment under the Vaccine Damage Payments Act? I say to Ministers: spend one day shadowing Sam or another constituent who is living with narcolepsy caused by Pandemrix, and I assure them that they will consider the disability severe enough for a long overdue payment from Government.

In addition to financial support through the Vaccine Damage Payments Act, children affected by Pandemrix require assurances over the long-term development and supply of the drugs that will alleviate their symptoms. Currently, my young constituent receives the drug Xyrem, which is expensive and not licensed for use in children. Sam receives it through a scheme funded directly by the UK Government and GSK, which has been a godsend to him and his family. However, there is a postcode lottery when it comes to access to Xyrem. Many trusts refuse to prescribe the drug, and until recently Sam’s prescription had to be collected from Sheffield Children’s hospital—a 60-mile round trip.

I am advised that the scheme that Sam and others like him currently benefit from is due to end in a year’s time. Sam’s mum advises me that he could not function without it, and as such I ask that the Government either commit to continuing the scheme in the long term or ideally provide an alternative that is secure and accessible to all. I also encourage them to consider opportunities to support research into medicines to alleviate the symptoms suffered by those affected. Clinical understanding of the condition is limited and there is definitely room for improvement.

I have a handful points on which I would be grateful for a response from the Minister. First, by virtue of GlaxoSmithKline requiring an indemnity, there was recognition that the vaccine carried a risk. Reliable studies now link the vaccine to narcolepsy. I would therefore welcome recognition from the Government of what has happened to those affected by Pandemrix and an apology to those families affected both by the incident and by subsequent refusals to provide support. It may be useful if the Government publish the terms of the indemnity provided to GSK so that the public are aware of the acknowledgement of the risk carried by the vaccine.

Moreover, in response to my recent written parliamentary question 64695, the Minister said she has no plans to amend the Vaccine Damage Payments Act. I ask her to think again, particularly when considering support for those affected who received the vaccine after August 2011, because it is clear that when the law fails to work for children like my young constituent, it is time for the law to change.

We know that the Swedish, Finnish, Norwegian, Icelandic and French Governments have already made payments to those affected. The Government should therefore support those who have been affected, and they should be concerned about and apologise for the delay in making payments and its effects. They should also put an end to legal action to prevent payments to those who have been damaged by Pandemrix and they should end the delay in processing claims and appeals. They should also recognise that such delays can and will undermine public confidence in vaccinations, which is something that all those with concern for public health will wish to avoid.

I end with some words from Di, describing how Pandemrix has changed her life. Di said to me:

“Life after the vaccine is totally changed. Our son needs 24/7 care, including getting up several times during the night. He is in almost continuous, intolerable pain, had severe headaches every day. He’s not able to go anywhere without careful planning, needs schedule naps, has several specialist meetings every month, so misses school. Sam is scared for his future and we are frightened for his safety.”