Oral Answers to Questions

Vicky Ford Excerpts

Tuesday 23rd April 2024 Commons Chamber

[Andrew Stephenson]

As the hon. Gentleman knows, the Government have committed to delivering 50 million more GP appointments and to making it easier throughout the country to see a doctor. In England in December, we delivered 25.77 million GP appointments compared with 23.31 million in December 2019—an increase of 2.46 million appointments each month. We need to continue to work with programmes such as Pharmacy First, and we are taking other steps to reduce the pressure on GPs so that they have more time to spend with their patients.

[Vicky Ford (Chelmsford) (Con)]

4. What recent progress she has made on retaining GPs.

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

General practitioners are a rock. They are the underpinning force of primary care. I want to take the opportunity to pay tribute to them for all they do for the health of the nation. My right hon. Friend is right to raise the issue of GP retention. During covid and since, GPs have been exhausted and the return to primary care provision has been difficult. The Government are doing a lot, such as improving digital telephony and reducing the administrative workload. I am about to launch a future of general practice taskforce to look at what more we can do to provide more support to this critical part of our primary care.

[Vicky Ford]

Chelmsford is a growing city, and it is very good that, compared with pre-covid times, we have more clinicians in our GP surgeries, but we need more surgeries as well. One new surgery is being built. I have been told that the limits that local district valuers impose on NHS lease costs make it increasingly difficult for developers to deliver new surgery buildings, not only in Chelmsford, but in other parts of the country. Will my right hon. Friend meet me and other affected MPs to see whether we can resolve that issue and help growing areas, where there are more houses, to deliver the new surgeries that we need?

[Dame Andrea Leadsom]

Of course I would be delighted to meet my right hon. Friend to discuss that issue, which several colleagues across the House have raised with me. She will appreciate that the District Valuer Services is crucial in ensuring value for taxpayer’s money from the rents that are charged for GP practices. Nevertheless, the Department is working hard to support better primary care facilities. I understand the point and would be happy to meet her.

Tobacco and Vapes Bill

Vicky Ford Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Victoria Atkins]

I am going to make a little progress, if I may, because I want to come to the age of sale.

On the point raised by my right hon. Friend the Member for Rossendale and Darwen (Sir Jake Berry) about the age of sale and the black market, tobacco industry representatives claim that there will be unintended consequences from raising the age of sale. They assert that the black market will boom. Before the smoking age was increased from 16 to 18, they sang from the same hymn sheet, but the facts showed otherwise. The number of illicit cigarettes consumed fell by 25%, and smoking rates for 16 and 17-year-olds dropped by almost a third. Consumption of illegal tobacco plummeted from 17 billion cigarettes in 2000-01 to 3 billion cigarettes in 2022-23. That is despite the further controls that this House has put in place in the meantime. Our modelling suggests that the measures in this Bill will reduce smoking rates among 14 to 30-year-olds in England to close to zero as soon as 2040. I hope that many of us in the Chamber today will still be here in 2040. This is our opportunity to play that part in history.

Thanks to constructive engagement with colleagues across the devolved Administrations, the measures will apply not just in England but across our entire United Kingdom, saving lives and building a brighter future. Having listened carefully to colleagues’ concerns about enforcement, we are making sure that local authorities will be able to keep every penny of the fixed penalties they bring in to reinvest in rigorous enforcement. In other words, we are looking not just at national enforcement, but at helping our very important and valuable local trading enforcement officers to keep the proceeds from the fixed penalties they hand out.

[Vicky Ford (Chelmsford) (Con)]

Does my right hon. Friend agree that, largely, the Bill will not affect people in this House but younger people, and that it is therefore incredibly important to listen to their voices on this issue? With that in mind, I wrote to every secondary school in my constituency to ask young people their views. The majority of young people in Chelmsford, when asked for their views, said they would support the measures in the Bill. It was not unanimous, but we work by majority. Given that it affects them and not me, I will be respecting their views when I vote today.

[Victoria Atkins]

I thank my right hon. Friend. Yet again, she reminds us what a brilliant local constituency MP she is. She has drawn out the voice of young people. When I pose questions about our NHS and the future I want to build for it—reforming it to make it faster, simpler and fairer—one thing I think about is the voice of younger people. If they are in work paying their taxes, they are paying for our NHS at this moment and they will be the users of it in the future. Part of my role as Health Secretary is to ensure that it has a sustainable funding model, that we are doing everything we can to increase productivity, and that we move the demand curve so that it celebrates its next 75 years.

--- Later in debate ---

[Wes Streeting]

Honestly, Mr Deputy Speaker, you just can’t help some people. I am trying to help the Secretary of State out and defend her against her own side, and now, to curry favour with them, she has turned on me. Now I know what it is like being in the Conservative party. This is like a 1922 committee meeting—absolutely absurd.

For the final time, let me just explain the situation we find ourselves in today. The Secretary of State is currently in government. This is her Bill. She is taking it through Parliament. She is perfectly able to run a consultation. I will support her in running a consultation, if that is the support she needs. [Interruption.] I am so pleased. If only I had known it was that easy. If all she needed was a bit of moral support from me to run the consultation, then you go, comrade—don’t you worry; I have got your back, and it is absolutely fine.

I am trying to be helpful to the Secretary of State this afternoon, but I just have to say to her that I am not sure that the best way to persuade her colleagues was to invoke the great cigar chomper, Winston Churchill. Some have estimated that Churchill went through 160,000 cigars in his time. Indeed, on one occasion, at a lunch with the then King of Saudi Arabia, Churchill was told that no smoking or drinking would be permitted in the royal presence. He responded:

“If it was the religion of His Majesty to deprive himself of smoking and alcohol, I must point out that my rule of life prescribed as an absolutely sacred rite smoking cigars and also the drinking of alcohol before, after and, if need be, during all meals and in the intervals between them.”

I appreciate the Health Secretary’s efforts, but I fear that Lord Soames was probably on to something when he said that his grandfather certainly would not have approved of this Bill.

Just before any Conservative Members decide to wage yet another culture war and accuse me of talking down one of Britain’s greatest Prime Ministers, I would just add to the historical record that it was thanks to the Labour party that it was Winston Churchill, not Lord Halifax, who became the leader of our country at a crucial time, and thank goodness that he did. Nevertheless, I do commend the Secretary of State on a good effort—she was close, but no cigar. Anyway, let us go back to the economic arguments of the Bill.

[Vicky Ford]

I want to go back to the point about consultation. I think that the hon. Gentleman has agreed that, for people who smoke cigarettes, moving on to vapes can be helpful. What he may not know is that people who have moved on to those vapes tell us that, if they are unflavoured and just taste of nicotine, they taste revolting. That is why many vapes are flavoured. That is why my hon. Friend the Member for Hyndburn (Sara Britcliffe) may be so concerned about making sure that people’s views are listened to before flavours are removed from the market.

It appears to me that the hon. Gentleman did not get that point, because he was refusing to believe that any such consultation was important. Therefore, out of respect to the people who use these products to stop smoking, can he confirm again that if he is in government at the time, soon after this Bill is passed, he will consult people and listen to their views before banning the products they use?

[Wes Streeting]

I am grateful to the right hon. Lady for her intervention. I think she makes a perfectly sensible point, actually, and I am perfectly open to lobbying from Conservative Members on how a Labour Government will behave after the general election—she seems to think it is a foregone conclusion, but I certainly do not; we will be working hard for every vote. I can reassure her that our concern has been about children becoming addicted to nicotine. In relation to adult use of vapes as a tool for stopping smoking, I think she makes an absolutely reasonable point about flavourless vaping, and of course she is right that we need to ensure that we get the regulation right on that so that we do not unwittingly deter people from stopping smoking. However, as I will come on to talk about when I come to the vaping section of the Bill, there is no excuse whatsoever for the kinds of flavourings and marketing of vapes that we have seen, which I believe have been deliberately and wilfully designed to addict young people to what is, let us not forget, a harmful substance. I make that very clear.

Anyway, back to the Bill—someone has to defend it, and I get the sense that there are not going to be too many on the Government side, so I will have a go at doing what the Prime Minister is too weak to do and take on the arguments of his own party. They say that the progressive ban on smoking is unconservative. Let me tell them what is unconservative: the heaviest tax burden in 70 years, and it will get heavier if we do not act to prevent ill health.

If we continue down the road that the Conservatives have put us on, with more and more people suffering, falling sick and falling out of the workforce, we will not just be letting those people down; we will all be paying a heavy price for it too. The costs of sickness and disability benefits are due to rise on the Government’s watch, from £65 billion this year to over £90 billion by the end of the next Parliament.

The budget for the NHS is £165 billion this year, and the health service is not coping with existing demands. If society continues to get less healthy, those demands will only rise. If the health service and our welfare service are to be made sustainable for the future, then we must act to prevent ill health in the first place. What better way to do that than by wiping out the leading cause of cancer? It is not just our public finances that are held back by ill health; so too is our economy.

--- Later in debate ---

[Vicky Ford (Chelmsford) (Con)]

The Bill sets two important principles crashing against each other: on the one hand, the principle of personal freedom, and on the other, the responsibility of a Government to act on public health. We are really lucky to live in a country that treasures personal freedom, and we should be careful of bans that take freedoms away.

However, smoking is the biggest preventable killer and costs the NHS and the economy billions every year. Most people who smoke wish that they had never started in the first place—that they had never had that choice—and I agree with them. I have lost weight, Madam Deputy Speaker, because I took a decision six months ago to give up alcohol, but that was far easier than giving up nicotine. People value the choice to make silly decisions. When they were told that they should not eat an easter egg all in one go, there was a public backlash. Given that this is about personal choice, I think it right that this be a free vote.

However, when I thought about the free vote, I realised that this does not really affect me; it affects young people, who have a right to be heard. That is why I wrote to secondary schools in my constituency to ask young people for their views. I am really grateful for the detailed feedback from three of those schools. I will not mention which schools, because they gave me their confidence and I do not want them to get in trouble with their peers.

One group reported back that the general consensus was that a ban was a good thing, and another said that they had mixed views. A third group sent me detailed comments from every single year 12 and 13 student of politics. In that group, the number of students supporting the Bill’s measures was more than double those who did not. The majority is even greater for the part of the Bill about vapes than for the part about tobacco. The children commented that the brightly coloured flavoured vapes are targeted at young people. They also worry about the environmental impact, especially of disposable vapes, and would like to have stronger limitations on disposable products than on reusable ones. They recognised that vaping can help adults to quit smoking and raised the concern that stronger restrictions on vapes may cause some adults to return to smoking, but they are also concerned about the lack of knowledge of the long-term impacts of vaping, especially for young people. Other students pointed out that fixing a set date of birth for those who are able to buy tobacco seems somewhat arbitrary, feels unfair and could be difficult to enforce, especially as those people get older. Some raised concerns that younger people will still obtain products—both vapes and cigarettes—from older people or from illegal sources.

All the groups commented on the need for enforcement measures, wisely pointing out that just passing a law in this House does not necessarily change behaviour. I was pleased that the Health Secretary said that local authorities will be able to keep the proceeds of fines in order to enforce this law. Some students were also concerned about the challenges that enforcement will pose to retail workers—the Government’s new proposal to introduce a specific offence of assaulting a retail worker may go some way to addressing those concerns. The final point, which I thought was really important to mention, was that some young people were concerned that if these products are banned, other items that are potentially even more dangerous will take over.

All those points have been mentioned individually by many colleagues in today’s debate, and every single one of them was considered by the young people in my constituency. I was deeply impressed by the thought they gave to the matter: they value freedom and choice, but when asked for their views, the majority of the young people of Chelmsford who responded said that they would support the measures in the Bill. It was not a unanimous opinion, and I respect those who did not agree, but in a democracy, the majority views are those that prevail. Therefore, out of respect for the majority view of the young people in my constituency—who will be affected by this Bill much more than any of us—I am going to vote for the Bill today, because it is their views on the Bill that will matter.

Oral Answers to Questions

Vicky Ford Excerpts

Tuesday 5th March 2024 Commons Chamber

[The Minister for Social Care (Helen Whately)]

As the hon. Lady will have heard me say earlier, we are grateful to international care workers who come to care for our loved ones in this country. We need to get the balance right between international recruitment and our home-grown care workforce. On the question specifically on dependants, I say to her that every care worker who comes here to do work in the UK has a choice as to whether to come here or not.

[Vicky Ford (Chelmsford) (Con)]

T8. I thank the Health and Secondary Care Minister for visiting the new medical school in Chelmsford yesterday. This is the first time that students have ever been able to train as doctors in Essex in its history, and the results are phenomenal. This is living proof of the Government’s commitment to train the NHS staff of the future. What progress is he making to increase work placements for students so that we can train even more doctors, nurses and people for important roles such as physician associates?

[The Minister for Health and Secondary Care (Andrew Stephenson)]

I thank my right hon. Friend for her question and her kind invite to visit her constituency. I pay tribute to all the work she has done to secure investment in Anglia Ruskin University. She is right to highlight the importance of delivering clinical placements as part of the long-term workforce plan. I assure her that we are working closely with NHS England and partners in health and education to ensure that happens.

Pharmacy First

Vicky Ford Excerpts

Wednesday 31st January 2024 Commons Chamber

[Vicky Ford (Chelmsford) (Con)]

It is great that people will be able to go to the pharmacy for their prescriptions, as well as for the products that they need, without the need to visit a GP. Chelmsford has some great community pharmacies, but Boots is closing three branches. Will my right hon. Friend meet me to discuss how we can ensure that the people of Chelmsford will be able to get to a pharmacy, in order for the initiative to work?

[Dame Andrea Leadsom]

I would be very happy to meet my right hon. Friend.

Oral Answers to Questions

Vicky Ford Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Victoria Atkins]

I think we all agree that a career as a midwife is just one of the most rewarding and fulfilling careers that one can hope for. That is why we have placed such priority on retention in the long-term workforce plan that we launched last year. The national retention programme for midwifery and nursing has prioritised five actions to support staff retention, including menopause guidance, because we know that that can be an issue for midwives, and valuing them and their contribution is also a key objective of NHS England’s three-year plan for maternity services.

[Vicky Ford (Chelmsford) (Con)]

As well as recruitment and retention, training matters. Anglia Ruskin University has a campus in Chelmsford and is the provider of the largest number of health and social care degrees in the country, training midwives, nurses and, since the medical school opened, doctors. Will the Secretary of State back the campaign to expand the medical school in Chelmsford so that we can train even more local people to work in our local NHS?

[Victoria Atkins]

I thank my right hon. Friend for raising her local college, which does amazing work for the whole of the NHS as well as in her local area. I may have to retain a discreet silence over that particular application but I know that if any Member is sure to advocate effectively for their local area, it is my right hon. Friend.

Countess of Chester Hospital Inquiry

Vicky Ford Excerpts

Monday 4th September 2023 Commons Chamber

[Steve Barclay]

Given the gravity—the seriousness—of the cases before the House, this issue is something that all Ministers are very seized of, but I will of course relay the right hon. Gentleman’s point to the Home Secretary. From talking to the team, I know that specific funding had been allocated for that in response to the seriousness of these cases, but of course, I will relay that point to my right hon. and learned Friend.

[Vicky Ford (Chelmsford) (Con)]

It is impossible to imagine the depths of the grief of the families of the babies who were murdered, and it is absolutely right that we try to help them to get the truth, to find out the facts and to make sure that it does not happen again, so I thank the Secretary of State for agreeing to the statutory inquiry and making sure that the parents are involved. In the Essex case, 2,000 people lost their lives and families have waited many years for that truth, so I thank the Secretary of State for progressing with the statutory inquiry and announcing the new lead of that inquiry today. Can he put that same energy into saying that the families will be involved in the terms of reference; that those terms of reference will be agreed swiftly; and that the inquiry will have the resources it needs to get to the truth, too?

[Steve Barclay]

Again, my right hon. Friend raises an extremely important point. I am extremely keen that the families, as well as the Members of Parliament in Essex, are able to engage with the chair of the inquiry and to shape that inquiry.

As part of the discussion in Chester with families about the relative merits of a statutory or a non-statutory inquiry, one concern was that a statutory inquiry sometimes takes much longer, which is why the point around phasing is important. Of course, the court case itself will have established significant areas of factual information that can be used by the inquiry. I hope my right hon. Friend can see that the decision to put the Essex inquiry on to a statutory footing underscores our commitment to getting families the answers they need.

Mental Health In-patient Services: Improving Safety

Vicky Ford Excerpts

Wednesday 28th June 2023 Commons Chamber

[Steve Barclay]

The hon. Lady raises a very valid point. There are real concerns about Tees. We considered that when considering the scope of the statutory inquiry. Given that significant work had been done in Essex, we decided to strike the balance by putting that on a statutory footing but enabling work to proceed at pace through HSIB on Tees and some other areas. The hon. Lady will know that the Care Quality Commission prosecuted the trust in May for a regulation 12 breach, and that significant work has already gone in; the report of the system-wide independent investigation was published last March. They are very serious issues on which I think there is concern across the House, and we stand ready to work with her and other elected representatives from that area as part of the wider work.

[Vicky Ford (Chelmsford) (Con)]

It is a deep, deep tragedy that, over the 20-year period, around 2,000 people lost their life under the care of mental health services in Essex. Families and survivors are right to want transparency and accountability. Given the slow progress of the independent inquiry, it is right that it now moves to a statutory basis.

When I spoke in Westminster Hall, I shared the testimony of a constituent who had been an in-patient in the early 2000s. She described being raped by another patient and being laughed at by staff when she asked for support. She described being able to make many suicide attempts, absconding from the ward and overdosing. She described how staff refused to treat her self-harm injuries and how she was repeatedly restrained and forcibly injected. I put on record my incredible respect for the people who are coming forward to relive their horrors and share their testimony. They are doing this because families and survivors want to know that change is embedded so that lives are safeguarded now and in the future. Will my right hon. Friend give assurance to my Essex constituents that mental health services in Essex will now be given the support they need to keep vulnerable people safe?

[Steve Barclay]

Having discussed that harrowing evidence with my right hon. Friend, I do not think any Minister could either forget it or not be moved. I found it an extremely moving experience to hear her talk about the experiences of a number of her constituents. She is right to praise those who come forward, and to recognise that it is often a difficult ask to relive the most awful circumstances, but it is important that families come forward so that we learn lessons and ensure this is not repeated.

My right hon. Friend is also right to highlight the two broad elements of learning the lessons of what happened in the past and maintaining services for the future. I am therefore happy to give her an assurance that we will work closely with her on support for Essex as lessons are learned through the statutory inquiry and as services continue to be delivered. We are working closely on that with the chief executive.

Mental Health Treatment and Support

Vicky Ford Excerpts

Wednesday 7th June 2023 Commons Chamber

[Vicky Ford (Chelmsford) (Con)]

As you and my hon. Friend the Minister are aware, Madam Deputy Speaker, there has been a tragic, historic issue of in-patient mental health deaths in Essex—it goes back to 2000—over a 20-year period. Roughly 2,000 people have lost their lives. An inquiry has been going on, but, as I said in the House in January, there has been deep concern about the lack of progress and the low level of engagement between Essex Partnership University NHS Foundation Trust and the inquiry. I also pointed out that families who have lost loved ones want to know that lessons have been learned, they want accountability, and, most important, they want to know that patients are not suffering the same today.

At the time, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), said that unless there was a

“quantum leap in the level of co-operation”—[Official Report, 31 January 2023; Vol. 727, c. 51WH.]

with the inquiry, it would move to a statutory basis. I know that the Secretary of State treats the matter seriously—he met Essex MPs recently and is close to making a decision—but it has now been four months since that debate, so may we please have a decision soon?

In the meantime, I recently met EPUT to find out what is happening with its service. I will tell some positive stories. In March, EPUT announced that it was going to launch a mental health urgent care unit in Basildon. We have all heard stories of people in mental health crisis going to A&E, waiting hours and hours, and then not getting the specialist service that they need, but that new specialist 24/7 centre saw 200 people in its first month. Instead of what happened historically in A&E—90% of people waiting a long time before being sent home without a care plan—90% of people see the experts within four hours and leave with a care plan. That is transformational. The unit is also piloting a 24-hour paramedic.

Demand in Essex is settling down. It rushed through the roof during covid but is now increasing in line with population growth. Complexity also rose during the pandemic. Prior to the pandemic, about 30% of those going into in-patient units needed to be detained. At the peak of the pandemic and post pandemic, that figure was 70%. It is now down to 60%. Our waiting time to see a psychologist, which rose to a year, is now down to 29 weeks. Vacancies for all positions have been filled, so the trust will be fully staffed from September and expects the waiting list to drop to zero.

Furthermore, EPUT is trying new technologies such as the new and innovative neuromodulation centre, which opened six months ago in Brentwood and is having great success. The trust is also encouraged by the Government’s announcements on electronic patient records. Enabling hospitals and mental health services to share patient records easily between them will make a huge difference. It is great news that the Government are behind that, but we need the funding for it.

Colleagues have mentioned eating disorders. Some may be aware that I suffered from anorexia when I was a teenager. It is still very difficult to talk about one’s own mental health. I encourage everyone in the Chamber to please be mindful of the language that they use; I have found some of the language used so far in the debate very upsetting. I completely agree with my hon. Friend the Member for Watford (Dean Russell) about being mindful of the tone that we use, because there will be people watching who are suffering with mental ill health, and we must not scare them away from getting treatment.

I am particularly concerned that what is being seen on social media today fuels eating disorders. The speed at which young girls in particular are shown eating-disorder content on social media by platforms such as TikTok is outrageous. I am glad that the Government are tackling that.

[Aaron Bell (Newcastle-under-Lyme) (Con)]

My right hon. Friend is absolutely right to mention social media, particularly in relation to teenage girls and eating disorders. I praise her for bringing her own experience to the Chamber. Another major contributor to the rise in mental ill health among young people in the last decade has been the isolation that social media can cause through bullying and so on.

[Vicky Ford]

My hon. Friend is completely right about online bullying. It is so important therefore that we get the Online Safety Bill through—it must not be delayed too much, although there are still issues to be looked at in the Lords.

I am very pleased that Ministers have announced that they will criminalise the intentional encouragement of serious self-harm, including eating disorders. I would like them to look again at the toggle on/toggle off issue that I mentioned last time we debated this, and—on another issue that is having an impact on children—to take seriously the need to prevent children from accessing online pornography, which is of an increasingly violent nature. Those matters are all related to the mental health of the nation.

--- Later in debate ---

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

As a now non-practising former consultant psychiatrist, I have a host of declarations I should make in terms of speaking in this debate. For the sake of brevity, I draw attention to my entry in the Register of Members’ Financial Interests and my declarations as part of my work on the pre-legislative scrutiny Joint Committee, which list them in full.

This is an important debate and I shall focus on two angles. One is the delivery of mental health care and treatment and the other is the framework for that. I want to celebrate today the rebuild of the Abraham Cowley unit in my constituency. It gets rid of the awful dormitories that have plagued mental health care and treatment for some time. They are now gone, and we will have a brand new, rebuilt mental hospital. In fact, tomorrow, I am going to the topping out ceremony on the site to see the progress in delivering that. It will make a huge difference to the delivery of mental health care.

I used to work as an in-patient consultant psychiatrist. When people come into hospital for in-patient psychiatric treatment, it is often at the most difficult times of their lives. It is critically important that our mental health estate is fit for purpose and is a therapeutic environment. For too long, the mental health hospital estate has been the second cousin to acute physical health care and I am delighted that we are driving change forward in my patch. If people need in-patient care and treatment, they will get it in a new hospital that is fit for purpose. I just want to celebrate that and thank everyone who has been involved in getting it over the line, as well as all the people who work in that sector, including those who are looking after the patients who would have been in the old hospital, which is now a building site, and going through a stressful period of transition while the new hospital is set up.

My second point is about the draft Mental Health Bill. A few years ago, my right hon. Friend the Member for Maidenhead (Mrs May), the former Prime Minister, suggested that we should review the legal framework we use when we treat people who are unable to consent or do not consent to treatment. Around every 20 years or so, we go through this process. We should be proud as a country that we have always been at the forefront of driving forward legislation and legal frameworks for dealing with people who cannot consent to treatment, the law of best interests and capacity. I was fortunate to be a panel member of the Simon Wessely review. I did that as part of my previous academic life, so Members can imagine my pride and delight in being part of the pre-legislative scrutiny Joint Committee on the draft Mental Health Bill.

I am slightly saddened by the debate today, because mental health—especially the frameworks we use to treat people who are severely unwell—needs to be above party politics. We are discussing the most invasive thing we do in medicine—detaining and treating people in hospital, sometimes for a substantial time. We need to think carefully about the right balance between choice, freedom and autonomy and making sure that people get the care that they need at the right time and under the right framework. I am glad that the Government have done pre-legislative scrutiny and we have worked on a cross-party basis to get this issue over the line. I hope that we will see the mental health Bill very soon.

My final point is about psychosis. The Government’s amendment mentions the treatment of psychosis, which I know is often missed out in these debates and when people talk about mental health. Psychosis is one of the most disabling mental disorders and far and away the most costly and impactful, because it can affect people when they are quite young—

[Vicky Ford]

It is incredibly helpful to have my hon. Friend’s detailed experience in this debate. Why does psychosis get missed out?

[Dr Spencer]

It is simply because of advocacy; the conditions debated tend to be mental health conditions for which people can advocate. We talk a lot about dementia, and the children of those suffering tend to advocate for them. For CAMHS, it is the parents who advocate. For common mental disorder, people are able to advocate for themselves, but psychosis can be—I do not want to make a broad generalisation—disabling and isolating, and can limit people’s ability to advocate for themselves. From my research, I know that psychosis can break down family relations and alienate people. I am nervous about broad generalisations, and for the most part people can get better and do very well, but in some cases psychosis can be very disabling and limit advocacy.

--- Later in debate ---

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to close the debate on behalf of the shadow health and social care team.

We have had a thorough debate and we have heard some heartbreaking, harrowing and concerning things during its course. The amendment that the Minister has put down in response to the motion is reminiscent of “Alice Through the Looking Glass”, because it does not bear any relationship to people’s lived experiences of the mental health system in England or the contributions made by Members from both sides of the House to the debate.

I pay tribute to all who have spoken today. There have been some incredible speeches. We heard from the hon. Members for Watford (Dean Russell) and for Penrith and The Border (Dr Hudson), from the right hon. Member for Chelmsford (Vicky Ford), and from the hon. Members for Runnymede and Weybridge (Dr Spencer), for Penistone and Stockbridge (Miriam Candidates), for Newcastle-under-Lyme (Aaron Bell), for Devizes (Danny Kruger), for St Albans (Daisy Cooper), and for Oxford West and Abingdon (Layla Moran).

We also heard from my hon. Friend the Member for Hemsworth (Jon Trickett), my hon. Friend the Member for Bermondsey and Old Southwark (Neil Coyle), who made an extremely powerful contribution, and my hon. Friends the Members for Chesterfield (Mr Perkins), for Batley and Spen (Kim Leadbeater), for West Ham (Ms Brown)—I ask the Minister not to forget her request for a meeting; she is certainly someone to whom it is difficult to say no—for Oldham East and Saddleworth (Debbie Abrahams), for Leeds North West (Alex Sobel), for Sheffield, Hallam (Olivia Blake), for Birmingham, Erdington (Mrs Hamilton), for Halifax (Holly Lynch), for Kingston upon Hull West and Hessle (Emma Hardy), for Wakefield (Simon Lightwood), for Luton South (Rachel Hopkins), for St Helens South and Whiston (Ms Rimmer), for Salford and Eccles (Rebecca Long Bailey) and for Blaydon (Liz Twist). Finally, we heard from my hon. Friend the Member for City of Durham (Mary Kelly Foy); I remind the Minister that she would like a response to her request for an inquiry into issues in her local area.

We are facing a mental health emergency in this country—

[Vicky Ford]

The hon. Gentleman has said that the Government’s amendment bears no relation to the reality of what people are seeing. In my speech I mentioned the creation of a brand-new facility for patients in mid-Essex, which means that people in crisis are not spending many hours in A&E but are going to a bespoke 24/7 centre. That is the sort of provision that I want to support, and it is mentioned in the Government amendment but not in the Opposition motion.

[Andrew Gwynne]

Of course we need facilities in every part of England, but the fact is that after 13 years, too many parts of England are falling behind. We know that the mental health crisis in this country has become worse on the watch of the right hon. Lady’s Government, and she should have a little contrition about the state of mental health services in England.

[Vicky Ford]

rose—

[Andrew Gwynne]

I will not give way. We have heard enough from the right hon. Lady, supporting her “Through the Looking-Glass” amendment which bears no relation to the reality.

As we have heard today, people who require mental health support, no matter where they live—except in the right hon. Lady’s part of England—will be confronted by a system that is buckling under the pressure of 13 years of Tory mismanagement, neglect and incompetence. The right hon. Lady shakes her head, but the figures speak for themselves. Last year, patients suffering with mental health issues waited more than 5.4 million hours in accident and emergency departments. There are 400,000 children currently waiting for mental health treatment, and 1.2 million people are waiting for community mental health care, with some patients being forced to travel more than 300 miles because there are no beds in their local area. My hon. Friend the Member for Hemsworth spoke powerfully about that. The Resolution Foundation has found that, of the 185,000 young people who are unable to work, nearly two thirds cite mental ill health as the reason. Suicide is now the leading cause of death in adults under 34, with about 18 people losing their lives every single day. As the cost of living crisis has worsened, we have also seen a knock-on effect on addiction and rehabilitation. Drug-related deaths are at a record high, and last year there were 9,641 deaths in the UK from alcohol misuse, a 27% increase on the year before.

Make no mistake: the emergency in mental health has become a public health crisis, and we need to see action. Our motion calls on the Government to adopt Labour’s plan to recruit 8,500 mental health staff to expand access to treatment, to provide specialist mental health support in every school, and to establish open-access mental health hubs for children and young people. That would be paid for by the closing of tax loopholes, because politics is about priorities, and Labour’s priority is to ensure that those who need mental health support have access to it in all parts of the country. Our priority is to build a Britain where patients start receiving appropriate treatment within a month of referral. I hope that those on the Government Benches will demonstrate that they share these priorities by voting for Labour’s motion today.

Staffing is just one part of the equation. Like any public health issue, addressing mental health requires a holistic approach that recognises its complex nature. That is why Labour has committed to a whole-Government plan to improve outcomes for people with mental health needs and to address the social determinants that drive mental ill health for many people. Our mental health can be influenced by a multitude of different things. Secure jobs, fair pay and good housing are all building blocks for a healthy life, physically and mentally, and unless we improve people’s lives in the round, positive change will remain out of reach.

It is for this reason that the next Labour Government will focus as much on prevention as we do on treatment. We will pioneer a transformative cross-departmental agenda with a mission delivery board at the heart of the Government ensuring that all Departments work to improve the wider determinants of health. We will boost capacity in mental and public health teams so that people can get the support they need before presenting at A&E or turning to substance abuse. We will also encourage the integrated care systems to identify opportunities to join up services within the community. Our aim will be for more patients to have one point of contact for appointments with a range of professionals and services. This neighbourhood team will include the family doctor, carers, health visitors, social prescribers and mental health specialists.

Our vision is to turn the national health service into a neighbourhood health service with the patient right at the heart of it. The benefits of this kind of work will travel far beyond improving the lives of individuals suffering from mental ill health. For instance, in my own region of the north-west of England there were over 140,000 calls to 999 from people in a mental health crisis last year, and in my own constituency local people spent over 6,500 hours waiting in A&E for mental health treatment. If we were to help people before they reached these crisis points, we would drastically reduce pressure on the wider health system and thereby improve patient outcomes right across the board.

The same is true of wider economic productivity. As we have heard in the debate, the Mental Health Foundation and the London School of Economics have estimated that poor mental health costs the British economy £117 billion a year. That is a phenomenal amount of money and a huge loss to our country’s economic power. Improving mental health outcomes is therefore not just a moral imperative—although it is certainly that—but a practical one, and one that is essential if we want the United Kingdom to prosper, as I hope and believe we all do. That is what we come to this House for. We want to leave our country in a better shape for our children than it has been for ourselves.

That brings me again to the motion. All Members of the House have the opportunity today to support a fully funded plan to improve mental health treatment. Those on the Government Benches can choose to put party politics first, but that will not change the fact that this Government have failed people on mental health. No matter what amendments they put before us, that does not change people’s real, lived experiences or the experiences of Members on both sides of the House who deal with the impact of mental ill health in their constituency casework. The system is crumbling and more of the same will just not cut it, so I am enormously proud to be supporting Labour’s motion today and I would strongly urge Members on both sides of the House to back it. It is time to give those suffering from mental ill health the treatment and support they deserve, and I commend our motion to the House.

--- Later in debate ---

[Maria Caulfield]

My hon. Friend is absolutely correct. As my hon. Friend the Member for Bosworth (Dr Evans) said, we had an event with the NFU yesterday, and that is exactly the point we wanted to make. It was my right hon. Friend the Member for Maidenhead (Mrs May) who set about changing the status of mental health, putting it on a level playing field with physical health, not just in the services we provide but in funding and staffing, with parity of esteem across the board.

Let us look at some of the progress that has been made over the last 10 years. The shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), said in her opening remarks that she is bored of this figure, but it is true that £2.3 billion of additional funding is being put into frontline mental health services, supporting another 2 million people to access NHS-funded mental health services.

We are already doing much of what shadow Ministers have set out this afternoon. We are already recruiting 27,000 additional staff into mental health services, with 20,000 of them already in place. My right hon. Friend the Member for Chelmsford highlighted the difference that is making in her local area. We are removing dormitory accommodation across the country through a £400 million capital programme, and 29 schemes have already gone through—that is 500 beds that are no longer in dormitory-style accommodation.

My hon. Friend the Member for Runnymede and Weybridge highlighted the difference that funding is making in his constituency. We are moving to a system of community crisis support and early intervention so that people do not get to a point where they need to be admitted. Our £190 million of capital funding is being used to build community crisis facilities up and down the country. We are investing in mental health ambulances: 20 are already in place, 40 will be in place by the end of the year, and 47 will be in place next year. The shadow Minister laughs about this, but when somebody is going into crisis, it is more appropriate that a mental health specialist team visits them in a mental health ambulance than an ordinary paramedic, who will inevitably take them to A&E.

Suicide is the leading cause of death in new mums, which is completely unacceptable. That is why we are investing in perinatal mental health services in every part of England—these services saw 31,500 women last year.

As we remove the stigma, it is important that we have the services to deal with the rising number of people who come forward and ask for help, as we want them to do. We have introduced three targets, the first of which is on access to talking therapies, where 75% of people should begin treatment within six weeks. Currently, 90% of people are doing so and we are meeting that target. When children and young people are referred for eating disorders, the target is that 95% should be seen within one week. We are currently at 77%, whereas last year’s figure was 61%, so despite the rising numbers we are seeing more children with eating disorders—

[Vicky Ford]

I was incredibly upset by the shadow Minister’s suggestion that I do not care about mental health. As someone who has suffered with mental ill health in the past and spoken in the Chamber about how hard it is to speak about that, I found that very upsetting. Mental health suffered greatly during the pandemic, especially that of children and young people—I was the children’s Minister at the time. We all know that we need to do better, which is why it is important that we learn about what is working now and about new innovations. On eating disorders, I particularly thank the Minister for getting the waiting list time down.

[Maria Caulfield]

I thank my right hon. Friend for that. It is important that we take the politics out of this argument, because no one in this Chamber, on either side, does not care about mental health.

The psychosis target we have introduced is that 60% of people should start treatment within six weeks, and we are currently at 72%. We are overperforming on many of those targets. NHS England has five new targets that we hope to introduce soon—

Draft Health Education England (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023

Vicky Ford Excerpts

Monday 20th March 2023 General Committees

[Will Quince]

My right hon. Friend is absolutely right. We need medics across the NHS in various functions: consultants, doctors, surgeons, allied health professionals, nurses, nursing associates, apprentices and so much more. That is exactly why we commissioned NHS England to undertake a long-term workforce plan. She will know that the Chancellor set out in the autumn statement, and reiterated in the recent Budget, that we will publish that plan very shortly—certainly this spring. It will also be independently verified. It will set out our plan and the workforce requirements for the next five, 10 and 15 years. It needs a bit of patience, but it is a hugely important piece of work because, as she rightly says, the NHS needs that workforce to plan for the future.

[Vicky Ford (Chelmsford) (Con)]

Carrying on from what my right hon. Friend the Member for Chipping Barnet said about the doctors and nurses of the future, one of the very successful things that this Government did five years ago was introduce 10 new medical schools. The one in Chelmsford at Anglia Ruskin University is hugely successful and the first new doctors will graduate in just a few weeks. It has some of the lowest drop-out rates anywhere in the country, and the new doctors want to stay locally. Will the Minister press the case for expanding very successful medical schools such as the one in Chelmsford?

[Will Quince]

I thank my right hon. Friend for her question. She is absolutely right. I was due to visit her medical school but, unfortunately, because of illness I could not. I still very much hope to do so. She is right that we need to train more medics domestically, although we have international recruitment. We increased the number of doctors we train by 1,500—a 25% increase to 7,500 per year. I urge her to wait just a little longer for the long-term workforce plan, which will set out our requirements for the future and how we go about ensuring that we fill the places and get medics in training. I am conscious that doctors are one of those groups.

Both of my right hon. Friends talked about planning, which is very much at the heart of the regulations. Their intention is to more closely align workforce planning, which is currently the statutory function of Health Education England, with the service and financial planning responsibilities of NHS England. That will enable service, workforce and finance planning to be properly integrated in one place. Nationally and regionally, it will build on the work that has been done to develop the NHS people plan. It will also help to drive reforms in education and training further and faster so that employers can recruit the health professionals needed to provide the right care to patients in the future.

Merging Health Education England with NHS England will simplify the national system, leading the NHS to end the separate lines of accountability that exist for the two bodies. Currently, Health Education England is responsible for workforce planning, education and training, but NHS England is responsible for culture, retention, international recruitment, workforce and leadership. Uniting those functions will help us ensure a joined-up and long-term view of what our NHS workforce needs for the future.

I pay tribute to Health Education England’s leadership and staff throughout the organisation’s 10-year existence. It has played a hugely effective role in the delivery of growth in the number of health professionals trained in England. It has promoted the creation of new roles, such as nursing associates, and spearheaded reforms to professional training workforce growth; record numbers now work within our NHS. It was hugely flexible and effective during the pandemic, including by supporting the deployment of students to the frontline at critical moments.

I am delighted that as of 1 April this year, Dr Navina Evans will become the chief workforce, training and education officer in the new NHS England. Sir David Behan, the chair of Health Education England, was appointed as a non-exec director of NHS England on 1 July. Those appointments are both important, because they will ensure that there continues to be excellent national leadership of NHS education and training.

I know there will be concern in some quarters that the changes pose a risk of budgets being used for other purposes. However, we have put in place a number of measures, including ministerial oversight, to ensure that that will not be the case. I am happy to elaborate on that later if required. Very briefly, we will include objectives on the workforce within NHS England as part of the NHS England mandate. We will continue to monitor and track expenditure on education and training with, as I said, a ministerial chaired board to provide that important ministerial oversight and governance of the workforce in NHS England.

Health Education England and NHS England already work closely together to ensure that the NHS has the workforce that it needs for the future. As I said in response to the question from my right hon. Friend the Member for Chipping Barnet earlier, we have commissioned NHS England to develop that long-term workforce plan for the next five, 10 and 15 years’ time. In effect, that plan will look at the mix, the number of staff required, and the actions and reforms that will be necessary across our NHS to reduce supply gaps and—importantly—improve retention.

Health and Wellbeing Services: East of England

Vicky Ford Excerpts

Wednesday 1st March 2023 Westminster Hall

[Vicky Ford (Chelmsford) (Con)]

I thank my right hon. Friend for leading the debate. One of the challenges we have had in my part of Essex for many decades is the difficulty of recruiting doctors, in part because no doctors were ever trained in Essex. It was fantastic news when, five years ago, thanks to the Conservative Government’s policy and support, a new medical school opened in Chelmsford, training doctors in Essex for the first time. The first doctors will graduate in just a few weeks, and I am delighted to tell my right hon. Friend that the drop-out rate on that course is only 3%—the average across the country is 8%—and many of those new doctors want to stay working locally in our area, which is fantastic. Will she and the Minister join me in supporting Anglia Ruskin University’s campaign to double the size of the medical school in Chelmsford?

[Priti Patel]

My right hon. Friend is correct. I remember having the opportunity to support the business case for the medical school around seven years ago, and I pay tribute to everyone who was involved in establishing that amazing medical school. In Essex in particular and in the east of England region, we are very proud to have the Anglia Ruskin University medical school. I have seen the campus—the size, the scale, the facilities—but also the enthusiasm of the students there. My right hon. Friend makes an incredibly important point, which is that we have to grow our own in Essex, and in the eastern region, and we need those students to be placed locally in GP practices to grow the footprint locally. I will come to that, particularly when I speak about primary care.

The point about the medical school, healthy life expectancy and the delivery of good health outcomes speak to the challenges we face in the region, which include heart disease, lung disease, diabetes, lung cancer, stroke, depressive disorders, falls and drug-related deaths. As our population grows, on top of the age profile changes that we are experiencing and will continue to experience, we will need more qualified GPs, but also medical specialists to serve those individuals and to support the community. The difficulties that we face comprise not only demographics, but the scale of the health challenges and, I say to the Minister, the issue of geography. The east of England is a diverse part of the country, and its rurality and coastal nature put pressure on services.

--- Later in debate ---

[Priti Patel]

I thank the hon. Gentleman for his comments. I have a whole section of my speech on GP access, particularly in the Witham constituency. That has been a contentious issue throughout my entire time as a Member of Parliament. He is absolutely right, and I have no doubt that his constituents and constituents in the east of England and across the country are facing the same challenges. There is a range of reasons for that, which I will touch on.

I think the Minister will be interested to know that in the east of England—this relates to facilities and access to care—per capita spend is £2,889, which is the lowest of any region and below the national average of £3,236. Like so much of the rest of the country, we face challenges. Ours is an ageing part of the country—our population is getting older—so we face disproportionate health and social care challenges and workforce demands. The east of England has the smallest number of nurses per 1,000 people of any region in the country. I urge Ministers to review not just the flexibility of dentistry contracts, but the east of England’s metrics on healthy life expectancy—this comes back to the levelling-up report—and provide more certainty to the region to address the disparities, which affect constituents across the board.

I also ask the Minister to look at what can be done to reduce ill health and early death, particularly as a result of preventable factors. Prevention is rightly a significant feature of the NHS, but we have serious issues in the east of England. Health providers and local authorities across the region would be really keen to engage with the Government on that. I am going to volunteer them all, because they offer themselves up constantly for new pilots and initiatives; we are very proactive. I pay tribute to Essex County Council, which has done a great deal of work on this issue, and other key providers that have the ability, capacity and capability to provide services.

As well as support for the region’s levelling-up ambition on healthy life expectancy, we are very keen to see improvements in wellbeing, where social prescribing comes into the mix. I say to the Minister and all our colleagues here today and people across the region that it is incumbent upon us to start to narrow that gap from top-performing areas. We need to start closing the gap, so that we start to see equity across these big challenges. As the levelling-up report has demonstrated, this is a difficult health indicator and target to measure, but we have the opportunity now to be innovative, and to work with new providers as well as our county council in the way that my hon. Friend the Member for Clacton (Giles Watling) has spoken about—a less bureaucratic and more flexible way that helps to drive local outcomes with our partners.

[Vicky Ford]

In my part of Essex, great work is already being done on levelling up. For example, it was never possible for people to get IVF in Mid Essex due to lower levels of funding, but that has now been levelled up, so that from 1 April, women will be able to get IVF treatment on the NHS in Mid Essex, which is really important to so many women who want to start a family

[Priti Patel]

I thank my right hon. Friend for her comments.

I have some very specific Witham issues. The Minister and the Department will be familiar with my bundles of correspondence on the Witham health centre. One of the most important ways that health and wellbeing in Witham, in Essex and across the East of England can be improved is by strengthening accessible services that are delivered within the local community. We have already touched on this point. That applies to the provision of health services in Witham.

I never tire of raising the needs of my constituents across the constituency and in Witham town; it is growing as a constituency and a community, and we are very proud of that. We have seen some amazing outcomes—for example, in education, in our rail services and in the infrastructure that we have been pursuing—but there is more to do. We have seen hundreds of new homes being granted planning consent and thousands of homes being built, with more residents coming to my constituency. Ours is a fantastic part of Essex—I do believe that the only way is Essex. Importantly, we now have a blend of new families and families who have lived in Witham for many generations. Like many towns, we have a growing population of elderly residents living in care homes and homes around the town, and of young people as well—we are a commuter town—with young families. With that blend and that increase, we need a new health centre.

Since the start of the pandemic three years ago, the four GP surgeries in the town have seen their patient lists increase by nearly 3% to almost 32,000 people. Between the four surgeries, there are just 13 full-time equivalent GPs, giving an average patient to GP ratio across the town of about 2,440. That is about 50% greater than the national average. The patients to GPs ratios across those four surgeries range from 2,045 patients per GP to 3,150 patients per GP, and each surgery is well above the national average.

With so many patients—in fact, this has been the case throughout my entire time as Member of Parliament for the Witham constituency—many constituents regularly report not getting appointments, and far too many are unable to take action when it comes to dealing with their own health concerns. Cancer risks are being picked up too late. In the light of the health disparities that I have already raised, serious and debilitating health conditions will not be serviced and attended to in a timely manner.

This will be no great surprise to the Minister or anyone in the Department, and I apologise to no one for the vigorous way in which I keep on raising the need for a health centre. It is one of the key projects that I have campaigned for during my time as Member of Parliament. The money has to come directly to Witham town. With four GP surgeries and more than 30,000 patients, there is a clear and compelling business case. I have offered to write the business case for the GPs myself. I have done everything to facilitate the GPs coming together, which has been rather challenging; the Minister will be well aware of the business models that mean that GPs do not always want to reach agreement and work together. I am sorry to report that those models have been a major underlying problem.

Having a new facility—this is the key point—would mean more specialist treatments and services delivered locally. It would give local constituents the greatest assurance that, whether they have young children or they are elderly, their needs will be taken care of within the town itself, and that there will be medical practitioners, therapists, nurses and others who can absolutely ensure that care is there for them. We should also bring in new providers and do much more on social prescribing. I am a great advocate of that, and we have to have a blended approach when it comes to access to primary care.

[Priti Patel]

I thank my hon. Friend for his comments about his beautiful constituency and the healthcare needs.

I want to press the Minister. For too long, my constituents and the residents of Witham have been waiting for a medical facility—a new health hub, as we have dubbed it—and I am afraid that there has been inertia in the way that people have come together locally to drive this outcome. I give credit to the new ICB and to one of our NHS colleagues heading up the ICB, Dan Doherty, who is trying to get GPs to come together. We are looking at a new practice centre and locations are being discussed, but enough is enough. We need this to come together, and it needs central leadership. We have spoken about the centralisation of money and resources. The one thing that central Government could do that would actually make a difference is to say that the project needs to go ahead, and then to tell the local ICB and GPs, “You will get the resources, the help and the support, because it is your job and your responsibility to deliver for local constituents and residents.” That is key.

We are, proudly, a growing constituency, and Tiptree is another major population centre where there are challenges in health provision. Tiptree is a very famous village, although its village status is sometimes questioned because it is growing and growing. The village is famous for its legendary jam-making business, which has a royal warrant, and we are very proud of Wilkin & Sons. The medical practice there has 12,000 patients registered but has just two practising GPs, so although the practice has a range of healthcare professionals working there, the level of GP provision is too low.

To come back to the point made by my hon. Friend the Member for Clacton, if we are to stop the pressures on A&E—for my constituency, the pressures are on Colchester Hospital, which is where Tiptree faces, and the pressures on the Witham side are on Broomfield Hospital, towards Chelmsford—we have to ensure that our local practices are supported and that we increase our GP ratios. That also speaks to the point made by my right hon. Friend the Member for Chelmsford (Vicky Ford) about the need to bolster the medical school and ensure that its graduates come to work in our GP practices. That is hugely important, and we in Essex absolutely believe that there is a great opportunity to increase GP provision. The medical school is outstanding. We want that link to be made and we need more GPs to come through from Anglia Ruskin. I will put in a shameless plug: come to Witham and Tiptree, and use the area as a network, through a new hub in Witham town, to then go further.

There have been interventions about dentistry, and I reiterate the point about the BDA’s statistics: around 93% of dentists in the east of England are not accepting any new NHS outpatients, and the proportion for children is 81%. We should pause and reflect on those statistics, which I find astonishing because of the health and wellbeing implications. We see poor dental hygiene and tooth decay in children, which is simply unacceptable. The Government announced a package of measures to improve dental health and access to NHS dentists in November, but the issue seems to be deteriorating for lots of reasons.

I know that the Government are doing much more on prevention, but we need what we have seen from the Suffolk and North East Essex ICB, which provided funds for children aged between two and eight to experience supervised brushing in early years and school settings. I am a big believer in our schools, which can do so much for children’s health and wellbeing. I said that we were all for innovation and pilots, and initiatives such as that should be supported across other schools to improve health and wellbeing with regard to dental care, and to show children what can be done and how to look after themselves. If we cannot get it right in the early years, frankly, we end up picking up the pieces later in life. This is about not just costs, but the wider health implications. There is so much preventive work we can do at the outset.

I will also take this opportunity to comment on our ambulance services across the east of England. I am sure that all of us here today—including you, Mr Hollobone, with Kettering Hospital—are all too familiar with the challenges for our ambulance services. Ten years ago, in 2013—I am sorry to say that I remember this too well—the East of England Ambulance Service was in crisis. There was a lack of investment in ambulances and paramedics, devastating concerns over patient care and appalling mismanagement of the board.

I pay tribute to colleagues across the east of England back then, because we came together, spoke with one voice and campaigned, to the extent that we forced the board of directors to resign and brought in new management—such was the scale of what was going on; it was appalling. The trust was turned around and I pay particular tribute to my noble Friend Earl Howe, who was a Health Minister at the time. Not only was he supportive, but he would sit in on meetings, come to the constituencies and sit with the ambulance trust. I also pay tribute to the successive chief executives at the trust who have improved plans and increased investment in ambulances and paramedics. It has been a slog, but we cannot overlook the hard work that has taken place over the past decade. I pay tribute to all those, in public service in particular, who gave up time with the trust to turn things around.

In January, I met the current chief executive of the trust, Tom Abell, and visited the call-handling centre in Broomfield, which my right hon. Friend the Member for Chelmsford will know. They are changing things. The call handlers are first class and I pay tribute to them; they are dynamic and so engaged. They are also smart, agile and triaging calls, which makes a tremendous difference. We want to support that and the right kind of patient outcomes, and they really care about patient outcomes.

We have to recognise that our paramedics and ambulances continue to face delays. That is preventing them from being out in the communities and reaching medical emergencies and injuries, so we still have complaints. I would welcome the Minister’s thoughts and insights on the east of England, and where further actions can be undertaken to improve services. I mentioned Broomfield Hospital in Chelmsford and Colchester Hospital for emergency care treatments. Importantly, those hospitals are part of the infrastructure and need to be reassured that the golden thread of integration reaches them, so that we do not see the appalling days of stacking that we saw many years ago and patients facing unnecessary delays.

Alongside that, we need reassurance and commitment from the Government to invest in and support hospitals, particularly in acute care settings in Essex and the east of England. I know that other colleagues will want to touch on that. An ageing population has more complex needs and our hospitals must be equipped to support that. Just as our ambulance service has been on a journey of improvement, the two hospitals have been on quite a journey of improvement. Broomfield was burdened with the most ridiculous private finance initiative costs when I became the Member of Parliament for Witham. I am afraid that those PFI costs—it was subjected to them by the previous Labour Government—were eye-watering, and the most horrendous debt had been put on the hospital at the time.

Colchester General Hospital has had one of the most interesting journeys. It spent long periods in special measures and required improvements, and it has now become integrated into the East Suffolk and North Essex NHS Foundation Trust. Many of the old issues have been resolved and there has been tremendous leadership there as well, notwithstanding the pressures faced during the covid pandemic. I pay tribute to everyone working at the hospitals who were involved in the turnaround plans. We have had periods pre and post pandemic with long waiting times.

Before the pandemic, Colchester hospital had a £44 million plan, which included the rebuilding of the day surgery unit and investment in a new orthopaedic centre. Those are important developments that we want to see come together. I look forward to hearing from the Minister, who is welcome to come to the constituency—or the region, I should say—at any time to see the panoply of issues that we have. Services need investment. There are improvements, but at the same time we need to get that golden thread, the integrated care, totally integrated.

As well as speaking about GP surgeries and hospitals, I will also mention our pharmacies, which play a vital role in providing health services to our residents. Pharmacies are located in the heart of communities. I have many brilliant pharmacies, and there are fantastic pharmacists around the country. They are the unsung heroes in our communities. We should recognise that they are desperate to play a stronger role in primary care. They want to help people to get treatments and help with prescriptions. I urge the Minister to speak to community pharmacists. I was concerned when I recently met a community pharmacist in the wonderful village of Tollesbury, where I was informed that the funding that they had received over the past seven years has been squeezed by 30%. I have been in touch with the Department about that.

Community pharmacists say that without urgent intervention, pharmacies will close, because of pressures on funding associated with prescription drugs and the NHS tariff. Pharmacies are to a certain extent subsidising the prescriptions that they issue in the community. The concerns are such that we are now moving towards a large number of permanent pharmacy closures, putting the safe supply of prescription medicines at risk. I have also heard that there are opportunities for the Government to empower pharmacies to do more by providing a blueprint for the future of community pharmacy, but that has to be backed by investment, which we are not yet seeing—we are seeing a continuing squeeze.

This issue is a no-brainer. In any village, constituency or community that has a community pharmacy, people can go there to be reassured if they feel unwell and want advice, rather than putting pressure on local GPs or, worse still, hospitals. With the son of a pharmacist now our Prime Minister, there is a great opportunity for the pharmacy agenda to take greater precedence and priority across the NHS and in our communities, so I want to press the Minister on that.

As my Essex colleagues are still here, it would be remiss of me not to raise one of the most contentious subjects that we face in Essex: the pressures of mental health services in our county, which has been raised in this Chamber before. I am sorry to say this, but we have seen families left devastated when loved ones in the care of mental health services have lost their lives, and families are now frustrated when they seek answers from the bureaucratic side because of the lack of accountability and transparency in the NHS trust.

On 31 January, my right hon. Friend the Member for Chelmsford held a debate on the Essex mental health independent inquiry, and our concerns are not being allayed at all. The inquiry’s chair, Dr Geraldine Strathdee, has raised many concerns. I pay tribute to her for her diligent work and boldness in speaking out and raising concerns about the lack of transparency and people not providing evidence to the inquiry. Both she and the current chief exec of the Essex Partnership University NHS Foundation Trust are encouraging and supporting staff to come forward to participate in this inquiry.

The Secretary of State, to his credit, has shown strong interest. He is trying to give us assurances that the inquiry may be put on a statutory footing, and we welcome that. However—I say this as a former Home Secretary who has been involved in setting up public inquiries into some of the most devastating issues—we would prefer evidence and information for the inquiry to come forward as soon as possible. I am conscious that—and I have said this to many of the families and victims—when inquiries are put on a statutory footing, it sometimes becomes harder for people to feel that they can come forward. The disclosure of names and personal details can become subject to some contention.

The point is that, for too long, families have been fobbed off with excuses and have had a lack of support. They have not been treated with respect and seriousness when they have raised concerns about their loved ones. Many are victims that have experienced the most horrific abuse at the hands of the trust. We now need the inquiry to deliver the answers that everyone is seeking. I would like the Minister to give an update on where we are on that.

Let me turn to another important point that is linked to the inquiry. We are experiencing too many mental health issues across society, and that is devastating. There is much more that we can do now with a focus on mental health and wellbeing in our schools, colleges and universities. We must put a particular focus on our young people. I am deeply concerned to hear of young people self-harming. That is not the subject of this debate, but it has been a subject in the House around online safety, the forthcoming Online Safety Bill and the roles and responsibilities relating to the type of information that is put out on social media networks and things of that nature. This comes back to prevention, but there is more that we can do on education and awareness. However, we must have specialist practitioners locally and in the community to provide the essential support. I would welcome some insights from the Minister on what education providers are doing in this area.

As a former Home Secretary, I will take the liberty of raising the issue of policing and mental health. In the police and crime plan, the Government that I was involved in made it abundantly clear that the police should not be the automatic backstop and default in dealing with mental health cases and patients. That therefore uses valuable police resources and means hours spent sitting in hospitals and A&E because mental health facilities were just not accessible. That is changing thanks to the Government and the initiative that I and the former Policing Ministers put in place, but it speaks to the mental health ecosystem and the numerous pressures on it.

On education providers and schools, constituents have raised concerns with me about how the health services are supporting children with special educational needs and disabilities. The Minister will be aware that health partners have a role to play in education, health and care plans for young students. However, the delays are not just cumbersome, but deeply stressful for pupils, families, parents and households. I am sure that all Members present can wax lyrical about the challenges in securing services, including speech and language therapy, to help young people and support them with their needs.

I go on about this a lot, but I believe that the money must follow the student. I still think we do not see enough of that. I have a terrible case of a youngster with very specific needs—high needs—as part of his education, health and care plan. However, the money that has gone to the school is just not following him in the way that it should for outcomes. We all know about delays in securing autism assessments. That is simply not good enough. We know it has been exacerbated by the pandemic, but we must do more to address the issue.

I will come to a near-conclusion by touching on a few other areas. I have already mentioned Essex County Council, which—all credit to it—has a strong record on investing in health, social care and wellbeing. I know that it would welcome details of its public health grant; it is that time of the calendar year when funding allocations come up. The council is also involved in piloting Active Essex, exploring what more can be done through prevention and enablement in health and social care systems to improve independence and health through increased physical activity.

On health and social care, I pay tribute to Essex County Council and Councillor John Spence. He is a remarkable individual who is really championing this area. If I may say so, central Government should spend some time with us in Essex to look at the innovative ways in which we are driving outcomes. The council has also transformed day services. It has established the “Meaningful Lives Matter” programme, and it is working with local employers to support adults with learning disabilities and autism. As a former employment Minister, I believe the more we can do to support people to get them into meaningful work, the better. It has great outcomes for health and wellbeing. We want more of that.

The council has a care technology service, which was launched in 2021 and is supporting 5,200 people. Of course, we all believe in making use of technology, and technology to improve health outcomes and independence is crucial. People do not want to be centralised or institutionalised; they want to be able to access services and live their lives. We are seeing good outcomes for people experiencing memory loss.

The council is working with the three integrated care systems that cover the county and supporting hospitals with discharges, which is obviously important from the social care perspective. The Essex Wellbeing Service has evolved. I emphasise that it is using both statutory and community service resources to support health and wellbeing outcomes. I invite the Minister to come to Essex to meet our colleagues—not just John Spence but the leader of the county council, Councillor Kevin Bentley. We are on the cusp of a good degree of innovation.

I am also keen to support new schemes that can help physical and mental health and wellbeing. I have touched on social prescribing, but I am also about to launch a new initiative with schools called “Get Witham Growing”. Among other things, I will involve schools in growing cosmos seeds from the national plant collection, as well as food seeds. We can get much more holistic outcomes, as well as the education, health and wellbeing benefits. Frankly, we can plant them now for future generations. I encourage other hon. Members to pick that up as well.

My right hon. Friend the Member for Chelmsford mentioned IVF support. Hormone replacement therapy treatments are also in the news. It is important to raise that point, because constituents have expressed concerns; people across the country would like reassurance from the Minister on that issue. I have already spoken about the health hub in Witham town, but phlebotomy services are something that we have raised consistently for over a decade. Access to blood tests is crucial; we want to see much more support in that area, both locally and across the region.

My final point is quite topical. I raise it because my constituency is growing. In fact, Essex is growing—not just from planting seeds; our population continues to grow. We have a lot of house building, with developments across Chelmsford, Clacton and Witham. They are not small. My right hon. Friend the Member for Chelmsford has Beaulieu Park, which is a massive development in various phases. I have Tollgate, which consists of thousands and thousands of new homes. In Witham town we have phased development, which used to be the old Witham Lodge development. However, something is missing when it comes to planning.

That is the whole issue when we speak about pressures on local health services. We are not seeing developer contributions stack up to meet the needs of the growing local population when it comes to the moneys going to local councils, whether through the community infrastructure levy or section 106, to get long-term, sustainable investments. Currently, we see developers offer cash amounts based on a formula relating to the number of new dwellings being constructed. It is impossible to refuse applications on these grounds—that is a planning point. However, we need to ensure that the cash amounts made available to councils and the NHS for new facilities actually materialise, because the money is currently not following people and outcomes.

[Vicky Ford]

My right hon. Friend is absolutely right that the money for infrastructure that comes from developments needs to go to every sort of infrastructure that our households need. I was deeply shocked to learn that over the past four years, Chelmsford City Council, under Lib Dem leadership, has not allocated a single penny to the NHS. Indeed, neither of the two projects approved by the previous Conservative leadership—the Beaulieu Park and Sutherland Lodge medical centres—has moved forward under Lib Dem leadership. Does my right hon. Friend agree that that is shocking, and yet another reason why we need to take back Conservative control of Chelmsford City Council this May?

[Priti Patel]

I absolutely agree. If I remember rightly, both my right hon. Friend and I have been involved in meetings with one particular health provider, which I will not name but which was totally inadequate, about Sutherland Lodge and another practice in my constituency.

The situation is untenable and totally unsustainable. I have pressed this point many times, but I would really welcome the Minister’s working with Ministers in the Department for Levelling Up, Housing and Communities to secure those health contributions. It is a bone of contention—one that our constituents and their Members of Parliament are angry about. That Department used to be called the Ministry of Housing, Communities and Local Government. My constituency has been subject to proposals for a garden community on which millions of pounds were wasted, when money from central Government—from the old MHCLG—could have gone, via new homes, into our community to give us a health hub in Witham, which would have bolstered health services across the constituency and across Essex, because we are growing.

I have deliberately referenced many parts of the NHS and the challenges around health and wellbeing in the region. I hope that I have shown how interconnected many of these issues are; none of them sits in isolation. That speaks to a wider point raised in a previous debate. While the size of the state grows and grows, the lack of integration in our communities and at the grassroots is a sticking point. It is very challenging.

I thank colleagues for their contributions. Importantly, this is a real moment for the Government to start to integrate our statutory service delivery, not just through the integrated care boards, but across local councils, and hopefully drive better outcomes in health and wellbeing across Witham, Essex and the east of England.