Oral Answers to Questions
Victoria Atkins Excerpts(4 days, 22 hours ago)
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Anna Firth (Southend West) (Con)
The Secretary of State for Health and Social Care (Victoria Atkins)
May I wish you a happy St. George’s day, Mr Speaker? I also wish the hon. Member for Bristol South (Karin Smyth) a speedy recovery; I hope to see her across the Dispatch Box soon.
The Government have invested significant sums to maintain and modernise NHS buildings, including £4.2 billion for integrated care boards this financial year. This is on top of the expected £20 billion for the new hospital programme. We have invested a further £1.7 billion for over 70 hospital upgrades across England, including in mid and south Essex.
Anna Firth
I thank the Secretary of State very much for the Government’s commitment to delivering the £110 million in capital funding for south Essex hospitals and for her recent visit to Southend hospital, where she saw in our emergency village how much £8 million can do in the hands of Southend hospital’s inspirational NHS staff. However, our aged buildings do also need urgent maintenance, so what can she also do to deliver the £38 million in maintenance funding also needed for Southend hospital?
Victoria Atkins
I thank my hon. Friend, and also wish her the very best of luck, as she is due to abseil down the hospital next month for its radiotherapy appeal. I very much hope she lands safely and does not trouble Southend hospital. I was delighted to visit the hospital at her invitation earlier this month, and I was very much impressed by the immediate improvements that the £8 million funding has meant in the Dowsett ward and for discharge and treatment times through accident and emergency. This is part of our plan, both through the urgent and emergency care plan and through our recovery plan for electives and the new hospital programme, to rebuild hospitals and provide that investment so that clinicians can use it to treat their local patients.
Navendu Mishra (Stockport) (Lab)
Last month, I met the chief executive of Stepping Hill Hospital in Stockport. She informed me that the primary out-patient building, which provides 85% of out-patient capacity, was recently condemned. While funding has been secured to build two additional wards, they will not be ready for at least 15 months, causing huge disruption in the interim. Fourteen years of underinvestment has left Stepping Hill Hospital quite literally crumbling. Will the Government provide urgent capital investment for Stepping Hill, so that my constituents and our brilliant NHS staff can have the facilities they need?
Victoria Atkins
I very much hope that the hon. Gentleman has already spoken to his integrated care board, because he will know that responsibility for local investment decisions rightly rests at local level. I can say that, as a Government, we have very much invested in hospital upgrades, including £4.2 billion going to integrated care boards this financial year. I hear the timetable he cites, but I encourage him to go to his integrated care board to ask what more it is doing.
Lee Anderson (Ashfield) (Reform UK)
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
The Secretary of State for Health and Social Care (Victoria Atkins)
We are committed to levelling up health, narrowing the gap in healthy life expectancy by 2030, and increasing healthy life expectancy by five years by 2035. That aligns with our mission to reform our health and care system to be faster, simpler and fairer.
Debbie Abrahams
In January, Professor Sir Michael Marmot published “Health Inequalities, Lives Cut Short”, which confirmed that between 2011 and 2019, driven by political choices, 1 million people in 90% of areas in England lived shorter lives than they should. The inequalities were amplified by Covid. These lives cut short are matched by shorter lives in good health. Does the Secretary of State believe in evidence-based health? If so, does she accept the overwhelming evidence that current levels of ill health reflect 14 years of escalating poverty, services that have been run into the ground, including the NHS, and the Government’s failure to do what they promised in 2019: level up?
Victoria Atkins
No, I do not, and I would point to the legislation that the Government brought forward last week, which is the largest and most significant public health reform that we can make to help the hon. Member’s constituents and those in other parts of the country who face inequalities. We know that smoking rates are disproportionately higher in poorer communities, which is one of the many reasons why we introduced such landmark legislation. It is just a shame that the Labour party felt that they had to whip their Members to get them to vote for it.
Theresa Villiers (Chipping Barnet) (Con)
Will the Secretary of State support Breast Cancer Now’s campaign to improve the uptake of breast cancer screening, especially among women in minority ethnic communities, because that is a good way to tackle health inequalities?
Victoria Atkins
I completely agree. Further on ethnicity and inequalities, I have not only prioritised women’s health as Secretary of State, but announced £50 million of research into maternity disparities for women of colour, given the worrying statistics associated with that. I have also responded to calls from brave constituents, put forward by hon. Members on both sides of the House, for further research into lobular breast cancer, because although it is responsible for 15% of diagnoses, we do not have the research or evidence to help women who are affected by it.
Imran Hussain (Bradford East) (Lab)
The reality is that someone living in the inner city in the Bradford district is likely to live 20 years less than those living in the more affluent parts of the region. That has not just happened; it is a result of 14 years of underinvestment in and cuts to not only our NHS, but our community services. Will the Secretary of State just admit that the Government frankly could not care less about people from places such as Bradford, because otherwise they would have accepted my levelling-up bid, which would have addressed this injustice at its core?
Victoria Atkins
I am so glad that the hon. Gentleman has mentioned levelling up, because presumably he will know from his bid that the 12 levelling-up missions are mutually reinforcing. Conservative Members take the approach that in order to help people with their health—[Interruption.] The hon. Gentleman is shouting at me. I thought that this answer would be important to his constituents.
Levelling up is not just about health. It is about the impact of education, housing and other matters in our environment, which is why in the forthcoming major conditions strategy we will tie together the conditions that have the most impact on a healthy life. We will draw together a cross-Government strategy to help people who are living with those conditions to live longer but also healthier lives.
Priti Patel (Witham) (Con)
The Health Secretary will know about the health inequalities across the east of England, including in Maldon district, which will only be made worse if the NHS’s plans to close St Peter’s Hospital in Maldon proceed. Does she agree that the levelling-up funding that has been made available to Maldon District Council should be prioritised to facilitate investment in new localised health services, so that those inequalities can be tackled?
Victoria Atkins
My right hon. Friend makes an important point. The purpose of the levelling-up fund is to help local areas to address what they need locally, rather than respond to diktat from central London. I encourage her to work closely, as I know she will, with local agencies, the council and others making those important decisions, so that their levelling-up announcements include health, as an integral part of her mission to improve the lives of her constituents.
Andrew Gwynne (Denton and Reddish) (Lab)
Back in the real world, the record of the last Labour Government is that we increased life expectancy by three years. Under this Government, it has stalled for the first time in a century, with people in Blackpool, for example, expected to live four and a half years less than the national average. Is the Secretary of State proud of this shocking record, or will people have to wait to elect Chris Webb in Blackpool South and a Labour Government at Westminster to finally turn the tide on health inequalities?
Victoria Atkins
As someone who is proud to have gone to school in Blackpool, I do not need a lecture from the hon. Gentleman about what Labour has done to the town centre, or about the important work that Conservatives in Lancashire are doing to help communities such as Blackpool. On Labour’s record, I gently point out, as I try to do at every orals, that the record of the Labour-run NHS in Wales is lamentable. People are almost twice as likely to be waiting for treatment in the Labour-run NHS in Wales. That is not a record of which to be proud.
Gill Furniss (Sheffield, Brightside and Hillsborough) (Lab)
Lilian Greenwood (Nottingham South) (Lab)
The Secretary of State for Health and Social Care (Victoria Atkins)
We are focused on delivering our women’s health priorities for 2024. Recent successes include new women’s health hubs opening across the country, with £25 million of investment; the investment of nearly £35 million over three years in improving maternity safety, on top of the extra £186 million already being invested each year; the success of the hormone replacement therapy prepayment certificates; and research into the important issue of maternity disparities, which I have already mentioned.
Lilian Greenwood
House of Commons Library figures reveal that one in four women with suspected breast cancer are waiting more than two weeks to see a specialist. The waiting list for gynaecological treatments has risen by 40,000 in a year, which means that there are now almost 600,000 women waiting, which is up by a third over two years. Labour has pledged to tackle that backlog, so that more women are seen faster. How much pain, misery or worse do women have to endure before this Government start prioritising their health?
Victoria Atkins
As the hon. Lady will know—she saw the statistics published very recently—we are in fact treating more people at earlier stages of their cancer. I want to take on her point about gynaecological waits, because that is important. We are spending more than £8 billion in this spending review period on additional elective activity, and investing in additional capacity, including community diagnostic centres and surgical hubs, many of which provide gynaecological tests and procedures. She may have missed it, but the latest published management information for March shows that the longest waits for gynaecology services have reduced by nearly 95% since their peak in September 2021. Of course there is more to do, but we are making progress. I thank all the doctors and teams who are involved in that important work.
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
Today, we have seen alarming figures pointing to the systematic de-prioritisation of women’s health, with 600,000 women in England waiting for gynaecological treatment, 33,000 women waiting more than a year, and under two thirds of eligible women screened for breast cancer in the last three years. Will the Secretary of State come clean and admit that under this Government, women’s health has become an afterthought?
Victoria Atkins
That is absolute nonsense. As I say, I have prioritised women’s health. I am pretty sure that I invited the hon. Lady to the women’s health summit earlier this year.
Victoria Atkins
She is very graciously saying that I did. The point is that I want women to receive the sort of care that we would all hope and expect them to have. I have prioritised that precisely because there are conditions, including gynaecological conditions, that have historically not received the attention they deserve. As our women’s health ambassador Dame Lesley Regan says, the NHS was created by men, for men. I am the Health Secretary who is sorting that out.
Mark Eastwood (Dewsbury) (Con)
The Secretary of State for Health and Social Care (Victoria Atkins)
We know that people in work lead happier, healthier lives. However, over 10 million “not fit for work” fit notes were issued last year. Most were repeat fit notes issued without any advice, so we are missing a golden opportunity to give millions of people the support they need to remain in work. That is why we are launching a reform of the fit note process to create a new system in which fit note conversations focus on what people can do, not what they cannot do. As part of this, the Government will consider shifting the responsibility for issuing fit notes away from GPs to reduce the pressures they face and to free up millions of appointments. I thank everyone who has delivered this vital work, and I very much look forward to hearing the results of the call for evidence in due course so that we can reform our welfare system for the sake of our constituents and our GPs.
Mark Eastwood
According to the Association of British HealthTech Industries, it takes, on average, 17 years for lifesaving and life-enhancing technologies to be adopted in the NHS. What steps is my right hon. Friend taking to speed up the adoption of new technologies so that the NHS can save more lives and improve patient outcomes?
Victoria Atkins
I dispute the 17-year figure, as it can vary across innovations. The figure is contested, but my hon. Friend raises an important point. We have a plan to prioritise the acceleration of patient access, thereby ensuring safe, effective and innovative medical technology for patients and the NHS. Our ambition is backed by funding, and we are reforming the medical technology regulatory framework, introducing the innovative devices access pathway pilot and launching frameworks to increase the availability of innovative products for the sake of patients across England and the United Kingdom.
Wes Streeting (Ilford North) (Lab)
The Health Secretary has promised that the Government will provide an extra 2.5 million dental appointments this year, but the dentistry Minister, the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), says the figure has
“a high likelihood of not being reliable”.
Which one of them is wrong?
Victoria Atkins
I am delighted to be able to tell the hon. Gentleman that we have modelled down the ambitions, so the figure we initially provided was higher than 2.5 million appointments. That is because we are focused on delivering the dental recovery plan, rather than overpromising.
The hon. Gentleman finds it easy to call our children short and fat, but he shies away from welfare reform, calling it shameless and irresponsible. He says he is ready to stand up to middle-class lefties, but Labour has never put patients first by condemning the unions that strike. He makes glossy promises about reforming the NHS in England, yet Labour has failed completely—
Mr Speaker
Order. I gently say that we need to get a lot of Back Benchers in, and I am sure both sides want to do that.
Wes Streeting
The last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history, which is a record that the right hon. Lady’s Government cannot begin to touch.
Back to dentistry, the chief dental officer says the announcement is “nowhere near enough.” The British Dental Association says:
“This ‘Recovery Plan’ is not worthy of the title.”
It also says that the recovery plan will not stop the “exodus” of dentists and will not meet the Government’s targets. Who should the public trust, and why should they trust the Health Secretary to deliver when her own adviser, her own Minister and, crucially, dentists all say that she is brushing the truth under the carpet?
Victoria Atkins
Again, let us bring ourselves back up to date. I know the Labour party likes looking back to the last time it found favour with the British public, but Wales is the up-to-date record of today. Labour’s lamentable record of running the NHS in Wales speaks for itself. If the hon. Gentleman is so set on reform, why on earth is he not helping his Labour colleagues in Wales to do exactly as he is promising? It is because they are empty promises, and because the hon. Gentleman and, I am afraid, the Labour party will step back from reform rather than grappling with the issues, as we are doing with our recovery plan.
Finally, on the dental recovery plan, within a month of the new patient premium being switched on, hundreds of surgeries have opened to new patients, which means that patients in the hon. Gentleman’s constituency and elsewhere are getting the care they need.
Sir John Whittingdale (Maldon) (Con)
Victoria Atkins
I thank my right hon. Friend for raising that matter. I understand that a consultation was conducted locally and that more than 5,000 local people and staff responded. Their feedback will be analysed by an independent research agency, which will produce a report for the Mid and South Essex ICB, and a meeting is due to take place in public in July. I will, of course, continue to take an interest in this matter.
Kirsty Blackman (Aberdeen North) (SNP)
The recent announcements on fit note reform are just the latest in a long string of attacks on the most vulnerable people in society. Sick and disabled people are being vilified, when, as the Joseph Rowntree Foundation points out, almost two thirds of those living in destitution live with a chronic health condition or a disability. The UK Government are continuing their track record in failing, and making life more difficult for, disabled people. Does the Secretary of State understand how much more difficult these changes will make people’s lives?
Victoria Atkins
These reforms are being brought forward because of a simply unsustainable rise in the number of people being given fit notes so that they cannot re-enter the world of work. We want to support people into work, not only because we believe that it is the best way to help them to recover, but because it helps us to fund the NHS. It is funded by people who work and pay their taxes. Again, I draw the hon. Lady’s attention to matters a little closer to home; sadly, Scotland’s record on health is very difficult to read and it includes the worst level of drug deaths in Europe. I encourage her to concentrate on how the SNP is running health services in its local area.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (Con)
Richard Burgon (Leeds East) (Lab)
Victoria Atkins
We switched on our fully funded dental recovery plan, in case the hon. Gentleman was not listening carefully earlier, on 1 March. Nearly 500 more practices in England are accepting new adult patients than at the end of January, and even more will do so under the dental recovery plan. We have plans to bring in new dental vans to help our most isolated communities. We are also bringing in the Smile4Life programme for children, because prevention must be a critical part of our dental recovery plan.
Steve Brine (Winchester) (Con)
Ministers will be aware of a rather boastful claim last weekend by the makers of Elfbar and Lost Mary vapes. They have already launched rechargeable, refillable products, which, with a coil in each pod, are not by definition single-use or disposable according to the published regulations. Can the Minister reassure the House and parents that they are alive to that and will pivot as necessary now that the Tobacco and Vapes Bill is going into Committee?
Victoria Atkins
I thank my hon. Friend for raising that matter, which shows the cynicism with which the tobacco and vaping industry is approaching these landmark public health reforms. On vapes, we have committed to consulting on the powers that we are adopting in the Bill precisely because we want to ensure that the regulations, when they come to the fore, address the realities of the market and the cynicism of the companies behind it, and help to ensure that our children do not continue being plied with these horrible items to get them hooked on nicotine.
Lee Anderson (Ashfield) (Reform UK)
Victoria Atkins
This is a very serious matter, which I have raised with the chief executive of NHS England, and asked her to raise with the regional director and Nottinghamshire integrated care board. We have done so because we believe that it might be a breach of the Nolan principles.
Maggie Throup (Erewash) (Con)
Just yesterday, the Office for National Statistics released data showing that alcohol-specific deaths in 2022 were 4.2% higher than in 2021 and a massive 32.8% higher than in 2019. Will my right hon. Friend now seriously consider a stand-alone alcohol strategy based on this worrying trend and agree to meet me and other interested parties to discuss a way forward to tackle alcohol-specific deaths?
Ruth Cadbury (Brentford and Isleworth) (Lab)
At my last surgery, a young woman told me that, thanks to the delay in her GP diagnosing her ovarian cancer, she is now infertile and receiving aggressive treatment. She had made four GP appointments over several months for her unexplained stomach cramps. Only in an emergency admission in another country was the ovarian cancer diagnosed and the tumour removed. How long will it be before the symptoms of female-specific conditions are taken seriously by our medical establishment, from initial training onwards?
Victoria Atkins
I thank the hon. Lady for raising this, and I very much send our best wishes to her constituent. The hon. Lady raises a really important point. The symptoms that women can experience are often very different for conditions relating not just to cancer, but to heart attacks, for example. Part of my prioritisation of women’s health is to get that message out to clinicians so that, as this case demonstrates so tragically, they are able to make the best and most prompt diagnosis for all women.
Matt Hancock (West Suffolk) (Ind)
What is the Secretary of State doing to ensure that the UK Health Security Agency has the budget and the capabilities it needs? The recent expansion of bird flu among mammals in the United States is a salutary lesson. Thankfully, there are no signs yet of human-to-human transmission, but it reminds us of the incredible value and importance of being vigilant in this space and having the best possible technology ready to respond as soon as possible.
Victoria Atkins
I thank my right hon. Friend for his question, and of course for his integral role not just during the pandemic, but in setting up the UKHSA. He will understand that I and others are keeping this under very close review, and the chief medical officer is briefing me as and when needed.
Alison Thewliss (Glasgow Central) (SNP)
Victoria Atkins
The hon. Lady raises an important point, and I ask her to write to me, please, so that we can look into it.
Will Quince (Colchester) (Con)
Given the importance of the UK’s life sciences sector, could my right hon. Friend update the House on commercial clinical trial recruitment?
Dean Russell (Watford) (Con)
I again thank the Secretary of State for visiting Watford General Hospital earlier this year, where we shared exciting plans for the new hospital, with preparation work starting this year, and construction starting by the end of 2026. I spoke with the West Hertfordshire NHS Trust leadership team this week, who confirmed that they are on track for that delivery within those timescales. Will my right hon. Friend please join me in thanking them for their hard work on that?
Victoria Atkins
I would be delighted to join my hon. Friend, and I thank him again for a really positive visit to his local hospital. That is a great example of a local MP working in his local area for his constituents and, what is more, delivering for them.
Greg Smith (Buckingham) (Con)
As a practical measure to improve radiotherapy waiting times, will the Minister agree to further work on the radiotherapy dataset, to include the collection of data on delays at each stage of the radiotherapy pathway, and by tumour type, so that we can better understand pinch points in services?
Daisy Cooper (St Albans) (LD)
West Hertfordshire Hospital Trust is at the front of the queue for the new hospital programme. We have the land, planning permission, building design, political and staff support, and enabling works are under way. But, like many other trusts around the country, the hospital trust is being asked to submit business case after business case. Will the Secretary of State clarify whether those delays are down to bureaucracy and the new hospital programme, or are they deliberate delaying tactics by a Government who do not want to release funds to hospitals before the general election?
Victoria Atkins
Normally, a Secretary of State would appear at the Dispatch Box after a question like that and say, “I refer the hon. Member to the answer I gave earlier.” On this occasion I will refer her to the question from my hon. Friend the Member for Watford (Dean Russell). He has just set out the business case for Watford General, which is great news, and I hope she will join him and me in welcoming that new hospital when it is open.
Tobacco and Vapes Bill
Victoria Atkins ExcerptsTuesday 16th April 2024
(1 week, 4 days ago)
Commons ChamberRead Full debate Tobacco and Vapes Bill 2023-24 View all Tobacco and Vapes Bill 2023-24 Debates Read Hansard Text Watch Debate Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Victoria Atkins)
I beg to move, That the Bill be now read a Second time.
Before I start, I should declare an interest: before I was elected to Parliament, I used to prosecute serious and organised crime, including organised crime gangs who attempted to import illicit cigarettes.
For a moment, I would like us to imagine that we are not in this historic and magnificent Chamber but instead standing at the entrance of a local hospital. A patient comes through the doors, struggling to breathe; smoking sent their asthma spiralling out of control. A minute later, another patient passes by; smoking caused the heart disease that they are battling. A minute later, another person comes in, and then another. That vicious cycle repeats itself nearly every minute of every day in our national health system, because here in the United Kingdom almost one hospital admission a minute is the human cost of smoking.
Smoking leaves people with premature dementia. It puts them in care, attached to oxygen, for the rest of their life. It increases the risk of stillbirth by almost 50%. It is responsible for 75,000 GP appointments every month, and it takes about 80,000 lives every year.
Dr Luke Evans (Bosworth) (Con)
I urge everyone who has come to the debate to go to a respiratory ward—I served on one for a year in my first junior doctor role—to watch people gasp for breath, struggle and fight, with their relatives asking you as a doctor to do something and you simply cannot. If the Bill is a step forward in stopping that situation, I am very much in favour of the Secretary of State taking it forward.
Victoria Atkins
I thank my hon. Friend for bringing to the Chamber his professional experience and the real-life consequences for his patients. If I may, I will unpack some of the details behind that invaluable intervention. The premise behind the Bill is exactly as he says—to stop the start—because there is no safe level of smoking and no safe tobacco product. In fact, it is the only product that, if consumed as the manufacturer intends, will kill two thirds of its long-term users.
The Bill is not about demonising people who smoke or stopping them from buying tobacco if they can do so today. It will not affect current smokers’ rights or entitlements in any way. Indeed, we want to help them to quit. We are supporting them by almost doubling funding for local stop-smoking services. Instead, the Bill is looking to the future, to give the next generation the freedom to live longer, healthier and more productive lives.
Sir Edward Leigh (Gainsborough) (Con)
How does the Secretary of State counter the Conservative argument that if we ban something, we massively increase criminality?
Victoria Atkins
I am extremely grateful to my right hon. Friend. I will genuinely come to that, because I know that that is a concern that colleagues have. I will develop my arguments, if I may, but I also remind him of my declaration of interest and, believe you me, I have no interest whatsoever in making life easier for smoking gangs. That is why as part of the package I will announce further funding and investment for law enforcement agencies both at the border and at local level.
Some have said that it is concerning that we are banning things. I totally understand the concerns of fellow Conservatives. We are not in the habit of banning things—we do not like that. We will bring these powers in only when we are convinced—following a no doubt robust debate, with the intellectual self-confidence that we have on the Government Benches—that there is no liberty in addiction. Nicotine robs people of their freedom to choose. The vast majority of smokers start when they are young. Three quarters say that if they could turn back the clock, they would not have started. That is why, through the Bill, we are creating a smoke-free generation that will guarantee that no one who is turning 15 or younger this year will ever be legally sold tobacco, saving them from the misery of repeated attempts to give up, making our economy more productive and building an NHS that delivers faster, simpler and fairer care. It is our responsibility—indeed, our duty—to protect the next generation. That is what the Bill will do.
Lilian Greenwood (Nottingham South) (Lab)
The Secretary of State is right that we should protect the next generation. Labour proposed the smoke-free generation legislation in January 2023. We voted to crack down on marketing vapes to children in 2021, but the Tories blocked it. I welcome this Bill, but does it not show that where Labour leads, some Conservatives follow? Is she not concerned about the number of her colleagues, who we see lined up in the Chamber, who will vote against this legislation today?
Victoria Atkins
That is a brave submission from the hon. Lady, given the debate in the Chamber yesterday. I certainly will not take lectures from Labour on this legislation. We are bringing it forward because we have looked carefully at the evidence. What is more, we have tempered it so that existing adult smokers will not be affected. If the message from the Labour party is that it wants to ban smoking for adults completely, it should make that argument. We have tempered this carefully to ensure that it only deals with future generations.
Sir John Hayes (South Holland and The Deepings) (Con)
I commend my right hon. Friend for her approach to young people smoking, her determination to deal with illegal tobacco and her crackdown on vaping, which is a menace to young people as these things are sold like an item of confectionery. Will she accept that in doing all those things, she needs to be open minded about how the Bill can be improved? The idea of a rolling age of consent, with the consequence that someone of 35 will be able to buy tobacco but someone of 34 will not and so on, is at best a curiosity and at worst an absurdity.
Victoria Atkins
I am extremely grateful to my right hon. Friend and close Lincolnshire neighbour. He knows that on any piece of legislation I will always want to listen to and do business with colleagues. The principle behind this legislation is that these emerging generations will never take up smoking. That is the point.
Victoria Atkins
I will just finish this point. We are bringing forward this legislation so that we stop the start from 2027. Future generations will not have that addiction to nicotine.
Ms Brown
Let me say from the outset that I completely support this Bill. In Newham, 22% of sales last year were to under-age children—higher than alcohol, knives, fireworks and so on—and a total of £135,000-worth of illicit tobacco products were seized in just six months. Will the Secretary of State ensure that councils get the resources they need to continue the vital work of keeping these products out of the hands of the young?
Victoria Atkins
Yes, I can assure the hon. Lady, because the illicit trade is often the greatest in the most deprived areas of the country, and I am about to develop exactly how we will help law enforcement. I very much understand the concerns across the House about ensuring that the illicit trade does not flourish.
Sir Jake Berry
Has my right hon. Friend seen the latest statistics that say twice as many schoolchildren smoke cannabis as smoke tobacco? It is already illegal—for all of us, not just children—to smoke cannabis. If a ban really worked, how can she explain those statistics? How can she show that this ban to stop people who are currently 15 will be different from the anti-drugs legislation that we already have?
Victoria Atkins
To be clear, is my right hon. Friend suggesting that we repeal the Misuse of Drugs Act 1971, under which cannabis is prohibited? Although I have no experience of it, I understand that the consumption of marijuana also involves the consumption of tobacco and cigarette papers. The point is that we are trying to move away from the idea that current youngsters will be able to buy their cigarettes legally in shops from the age of 18 in 2027, precisely because we want to ensure that they can lead longer, healthier lives. In a moment I will come to some of the myths that the tobacco industry has put around about the impact of introducing age restrictions on cigarettes, which will be interesting evidence for those who are concerned about that.
Jim Shannon (Strangford) (DUP)
First of all, I commend the Secretary of State and the Government for bringing forward this legislation. I support it because I believe it is right, but I have been contacted by vaping groups. My right hon. Friend the Member for Belfast East (Gavin Robinson) and I met some last week. They sent me a small comment, and I want to ask the Secretary of State a quick question about it, so that we move forward with consistency to try to achieve something.
Those groups referred to the impact assessment report by the Department of Health and Social Care, and said that it fails to consider potentially detrimental effects of restricting vape users and smokers looking to switch. I think we all try to be helpful and constructive in our comments in this Chamber, so being constructive, they requested a vape retailer and distributor licensing scheme in the Bill. The industry has developed a comprehensive framework for such a scheme, which is designed to deal effectively once and for all with underage and illicit vape sales—a situation that could get worse. Does the Secretary of State intend to develop a vape retailer and distributor licensing scheme?
Victoria Atkins
I am extremely grateful for the hon. Gentleman’s support. We understand the level of lobbying that has been undertaken by both the vaping industry and the tobacco industry. We know that the vaping industry has pushed that as one of its lines. In the current vapes market, when walking into a local shop or a newsagent the vape products can be seen on sale next to the till, often next to the sweets—the part of the shop that children will be very attracted to, if my experiences are anything to go by. The industry markets them in very cynical ways. We are saying that it is already unlawful to sell vapes to under-18s, but we want to take the powers in this legislation to consult on flavours, design and so on, to ensure that vapes are sold as they are intended—to help adult smokers to quit, because no child should ever vape.
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.
Ian Paisley (North Antrim) (DUP)
I thank the Secretary of State for giving way. She knows that I take a particular interest in the impact of retail crime. The British Retail Consortium indicates that there are about 1,300 acts of violence against shopkeepers across the UK daily. It has been suggested that one of the biggest triggers of attacks on shopkeepers is asking for proof of age. What additional resources can be put in to assist retailers and ensure they are protected from attacks?
Victoria Atkins
The hon. Gentleman raises a very fair point. Interestingly, the latest survey of retailers shows—I think I am right in saying it—that the majority of retailers support this policy, but he knows just how carefully the Government have listened to the concerns of retailers. My hon. Friend the Member for Stockton South (Matt Vickers) has led a relentless campaign on this issue, and I was really pleased that the Home Secretary was able to announce in recent weeks a specific crime relating to violence against retail workers.
Giles Watling (Clacton) (Con)
I smoked until 30usb years ago and it was a very hard business to stop the evil weed. I come from a completely different era and I am considered something of a dinosaur. [Hon. Members: “Never!”] But I do still hope to be here in 2040. I wish to God that vapes had been around when I was going through the process of stopping smoking. Do we not need to be very careful that the Bill does not throw the baby out with the bathwater and stop helping people come off the evil weed?
Victoria Atkins
First of all, I completely reject my hon. Friend’s suggestion that he is a dinosaur. He brings a great energy and effervescence into the Chamber—or indeed any social situation. He articulates really well the struggle of addiction to nicotine and how tough it can be to give up. That is not a judgment on anyone; the substance is designed to addict. That is how the sales pitch is made. What we are trying to do is stop children being ensnared in that way. He is also right that at the moment the evidence suggests that vaping is a good way to help existing smokers to quit. If you do not smoke, please do not vape. Certainly, children should never vape. What we have tried to do with the Bill is build a balance in, so we are taking powers to look at packaging, flavours and so on. There will be a thorough consultation before any regulations are set, because we want to ensure that we are helping adults to quit, but in a way that is considered and well designed. I am extremely grateful to him for raising that point.
Alexander Stafford
I am listening very carefully to what my right hon. Friend is saying. She outlined how the consumption of cigarettes has collapsed over the last couple of decades, and my right hon. Friend the Member for Chelmsford (Vicky Ford) talked about how the young people she reached out to do not want to smoke any more. Is that not the heart of the matter? That is why I think the Bill is fundamentally wrong and misguided. Young people are not smoking. It is not cool to smoke. The Bill should be focused more on the vape side of things: illegal vapes, supercharged vapes, the colour and flavour of vapes. We are debating cigarettes, which are naturally going out of existence anyway, rather than focusing on the dangerous vapes that are addictive for young children. That is where the Government should put their focus, rather than wasting time talking about something that is dying out anyway.
Victoria Atkins
Sadly—I say this genuinely—there is nothing inevitable about a decrease in smoking rates. Indeed, in 2020 the United States saw the first increase in tobacco sales in 20 years, and in Australia in 2022 the proportion of teenagers smoking increased for the first time in 25 years. I am reminded by a Minister that here in the United Kingdom 100,000 children and young people take up smoking every year. We must not be lulled into a sense of inevitability and security, mindful as I am of how very clever the tobacco industry is at lobbying its messages because we are threatening its business model. As Conservatives, we must take into account that this is happening today, so we must ensure we tackle it head on.
Nickie Aiken (Cities of London and Westminster) (Con)
I thank my right hon. Friend for giving way. She is making a very important point about young people and children smoking today. It is not just about cigarettes. Shisha smoking, in particular in Westminster, Marylebone and Edgware Road in my constituency, has become very fashionable for young people. An hour of smoking shisha equates to 100 to 200 cigarettes within an hour. Will she confirm that shisha tobacco will be included in the Bill?
Victoria Atkins
I thank my hon. Friend for bringing the City of Westminster right into the Chamber. There are, in fact, five times more people in England today smoking non-cigarette tobacco, which includes cigars and shisha, than there were a decade ago. Worryingly, the greatest increase is in young adults. That is why we have said that tobacco in all its forms is a harmful product, and that we therefore wish to ensure we are consistent in the policy and the messaging that this is about helping young people to stop the start.
Victoria Atkins
I am going to make some progress and then I will give way.
As I have said, the tobacco industry questions the necessity of the Bill on the grounds that smoking rates are already falling. It is absolutely correct that smoking rates are down, but as I said, there is nothing inevitable about that. Smoking remains the largest preventable cause of death, disability and ill health. In England alone, creating a smoke-free generation could prevent almost half a million cases of heart disease, stroke, lung cancer and other deadly diseases by the turn of the century, increasing thousands of people’s quality of life and reducing pressure on our NHS. An independent review has found that if we stand by and do nothing, nearly half a million more people will die from smoking by the end of this decade. We must therefore ask what place this addiction has in our society, and we are not the only ones to ask that question of ourselves. We know that our policy of creating a smoke-free generation is supported by the majority of retailers, and by about 70% of the public.
The economic case for creating a smoke-free generation is also profound. Each year smoking costs our economy a minimum of £17 billion, which is far more than the £10 billion of tax revenue that it attracts. It costs the average smoker £2,500 a year—money that those people could spend on other goods and services or put towards buying a new car or home. It costs our entire economy by stalling productivity and driving economic inactivity, to the extent that the damage caused by smoking accounts for almost 7p in every £1 of income tax we pay. As Conservatives we are committed to reducing the tax burden on hard-working people and improving the productivity of the state, which is why this Government have cut the double taxation on work not once but twice, giving our hard-working constituents a £900 average tax cut. That is a moral and principled approach.
Having celebrated the first 75 years of the NHS last year, I am determined to reform it to make it faster, simpler and fairer for the next 75 years, and part of that productivity work involves recognising that we must reduce the single most preventable cause of ill health, disability and death in the UK. This reform will benefit not just our children but anyone who may be affected by passive smoking, and, indeed, future taxpayers whose hard-earned income helps to fund our health service. Today we are taking a historic step in that direction. Creating a smoke-free generation could deliver productivity gains of £16 billion by 2056. It will prevent illness and promote good health, help people to get into work and drive economic growth, all the while reducing pressure on the NHS.
Alex Cunningham
Of course, the tax burden is the highest it has been for some considerable time. I welcome the Bill, but the Khan review estimated that the Government’s smoke-free ambition would not be fulfilled in poorer communities until 2044, and there are many such communities in my constituency, so how will the Bill tackle that issue? Will it really be another 20 years before we see a result in poorer communities?
Victoria Atkins
No, because, as I have said, the modelling suggests that among the younger generation smoking levels will be close to zero by 2040. As for the hon. Gentleman’s point about tax, I do not remember him voting against the Government’s furlough scheme and other support during covid; nor do I remember him complaining that we were trying to help people with the cost of living. We as Conservatives understand that this is sound money, rather than the magic money tree that will somehow fund Labour’s £28 billion black hole.
Anthony Mangnall (Totnes) (Con)
I am somewhat perplexed by this debate, and indeed by the Bill. I do not consider it to be enforceable, and I also think it fails to take into account the effective tax measures and health campaigns that have been run by successive Governments to reduce the number of smokers. Nor does it respond to the fact that, in the long run, bad and poor diets are likely to kill more people than smoking. According to a recent study conducted by the Institute for Health Metrics and Evaluation in Seattle, more people are dying from malnutrition than from smoking. There is a principle at stake here: should the Government step in and deal with people who are eating unhealthy food?
Victoria Atkins
I am, of course, responsible for healthcare in England, so I will not trespass on the health needs of people in—as I think my hon. Friend said—Montreal. As for the Bill, it is intended to help children and young people to end their addiction to nicotine, which we know is one of the most addictive substances. As I said earlier, we should not assume that decreases in smoking rates such as those we have seen are inevitable; indeed, I have cited countries in which we have seen an increase. We also know that tobacco is being consumed in ways that are different from the ways in which it was consumed, say, 20 years ago. My hon. Friend the Member for Cities of London and Westminster (Nickie Aiken), for instance, mentioned the rise of non-cigarette tobacco smoking. We are trying to address that, for the health of the individual as well as the wider health of society.
Several hon. Members rose—
Victoria Atkins
I have already taken an intervention from the hon. Member for North Antrim (Ian Paisley). I will take one more, from the hon. Member for York Central (Rachael Maskell), and then I will make some progress—although I will give way to my hon. Friend the Member for Dartford (Gareth Johnson) in a moment.
Rachael Maskell
The Secretary of State has talked about addiction to nicotine. If, as she has suggested, vaping is a pathway to stopping smoking, why does she not envisage a vape-free generation arriving in parallel with a smoke-free generation, so that we can have a nicotine-free generation across the board? Why does she not expand her legislation to ensure that young people take up neither smoking nor vaping?
Victoria Atkins
The House has already legislated to ensure that vapes cannot be sold to people under 18. However, as we are seeing in our local shops, the vaping industry is finding ways of marketing its products that seem designed for younger minds and younger preferences. Once the Bill has been passed, that age limit will be maintained for vaping but, importantly, from January 2027 onwards we will not see the sale of legal cigarettes or tobacco to those aged 18 or less.
Vicky Foxcroft (Lewisham, Deptford) (Lab)
Will the Secretary of State give way?
Victoria Atkins
No; I want to make some progress. I want to say something about the measures on vaping because, as Members have already demonstrated today, there is a great deal of interest in the subject.
As any parent or teacher will know, there has been a dramatic and dangerous increase in youth vaping. At least one in five children have tried it. Many will say that the solution is simply to enforce the law, and of course that is a vital component, which is why we are investing £30 million in our enforcement agencies and hitting cynical businesses that sell vapes to children with on-the-spot fines. However, we must and will go further, because vaping damages our children’s future. It could damage their lungs while they are still developing, intensify the long-term pressure on the NHS, and damage their concentration at school—a point that many teachers have made.
We cannot replace one generation addicted to nicotine with another, and vapes are cynically marketed towards our children. They are sold at pocket-money prices, they share shelf space with sweets, they are branded with cartoon characters, and they are given flavours such as cotton candy and watermelon ice. Our children are being exploited, and we cannot and will not let that continue. The Bill will give us powers to crack down on child-friendly flavours and packaging and to change the way in which vapes are displayed in shops—measures on which we will consult.
Through separate environmental legislation we are banning the disposable vapes that young people favour and that do so much harm to our planet. Some 5 million are thrown away, either in bins or on our streets, every single week. That is equivalent to some 5,000 lithium car batteries from electric vehicles being thrown away every year. We have a responsibility to tackle the harm to our planet that is perpetrated by the vaping industry. While vapes can be helpful in assisting adult smokers to quit, our message remains clear: if you do not smoke, do not vape, and children should never vape.
Gareth Johnson (Dartford) (Con)
I thank the Secretary of State for giving way; she is being very generous. The Bill gives her wide-ranging powers in relation to the flavours of vape liquid, packaging and so on, but does not oblige her to consult widely or look at impact statements. In fact, the word “consultation” does not appear anywhere in the Bill. Will she give the House a commitment that she will consult fully before exercising any powers given to her by the Bill?
Victoria Atkins
I thank my hon. Friend for highlighting that. I give a commitment here at the Dispatch Box that we will consult. We are very conscious of the complexities of this issue. We want to get it right, and my hon. Friend has my absolute undertaking that we will consult before regulations are brought before the House.
Victoria Atkins
If the hon. Gentleman wants to dive in before I conclude, I will let him do so.
Ian Paisley
That is kind of the Secretary of State. I appreciate her taking these interventions.
Given that this a flagship policy for the Government, will the Secretary of State give me a guarantee from the Dispatch Box that the Bill will apply equally to all parts of the United Kingdom? I have raised a number of concerns about the fact that because we have a land border with the European Union, the EU will insist, under the Windsor framework, that it can block the implementation of the Bill in Northern Ireland, as it did with the Danish Government when they tried to introduce a similar measure. Can I have a guarantee that if the Bill will apply from 2027 in the United Kingdom, it will apply in the United Kingdom of Great Britain and Northern Ireland?
Victoria Atkins
I thank the hon. Gentleman for raising a really important point. May I, through him, thank the new Northern Irish Health Minister, who has been very collaborative in bringing forward what needs to be brought forward as quickly as possible, given the historical context, so that we can have the Bill aligned across the United Kingdom? Our intention is absolutely as the hon. Gentleman describes: it applies throughout the United Kingdom. Of course, if he or his colleague in Belfast have concerns that there may be ways in which it could somehow be circumnavigated, we will listen carefully, but I should be clear that our intention is that the Bill applies to all children and young people across the United Kingdom, because we want to protect children living in Northern Ireland just as much as those in England, Wales and Scotland.
Rehman Chishti (Gillingham and Rainham) (Con)
On the Secretary of State’s point about tackling illicit tobacco, I raised that question with the then Prime Minister in 2016, because in Medway we had one of the highest rates of illicit tobacco sales. The maximum sentence that can be given for the supply and sale of illicit tobacco is seven years. As part of the strategy to deal with illicit tobacco, will the Government look to increase sentences for its sale and supply? The Secretary of State is right to say that the Conservative party is committed to lower taxation, but tax avoidance and evasion costs this country £2 billion. If we do not get things right with regard to the banning of cigarettes, which I do not agree with—I think we should do it through education and awareness—we will get more people buying illicit tobacco. That cannot be right.
Victoria Atkins
My hon. Friend gives me the ideal opportunity to talk about my favourite criminal offence: cheating the public revenue, which is a criminal offence with very settled law. It has a maximum sentence of life imprisonment, and I have deployed it myself against the organised crime gangs to which I referred at the beginning of my speech. A sensible prosecutor will always look at that criminal offence, because it is settled law and good law, and it has a maximum sentence of life imprisonment for those who indulge in it.
Victoria Atkins
I am going to conclude. In fairness, I have been generous with my time.
We want to build a brighter future for our children and grandchildren, which means moving from the tossing sea of cause and theory to the firm ground of result and fact. The result of this legislation will be to free future generations from the tyranny of addiction and ill health. The facts include that parents worry about youth vaping and want us to take on the tobacco and vaping industries. The result and facts of this change will save hundreds of thousands of lives, reduce pressure on our NHS and increase millions of young people’s chances in life. The decisions we make today will stand the test of time. For those many reasons, I commend the Bill to the House.
Mr Deputy Speaker (Mr Nigel Evans)
I will try not to impose a strict time limit. If I were wishing to speak, I would start to think about taking seven minutes for my contribution. That does not apply to the shadow Secretary of State.
Wes Streeting
I do not know whether there is a problem with the speaker system in here, because this is the second time I have had an intervention after answering the question. I have already said that the Government have consulted on measures to clamp down, and I am absolutely not against the Government talking to people who, like the hon. Lady, have used vaping as a smoking cessation tool. In fact, I fully support the point she is making, which is that vaping can be a really effective tool to help smokers to quit smoking. I am in favour of that; that is good for health. If the Government want to talk to and engage with people who vape as part of the passage of this Bill, that is absolutely fine. What I am not in favour of is tying the Secretary of State’s hands when she wants to do more, and more quickly, to prevent children becoming addicted to nicotine.
Victoria Atkins
Just to be clear, we will consult on this. It is a simple question that requires a simple answer: will Labour consult further?
Wes Streeting
Mr Deputy Speaker, we are now in this parallel universe where the Secretary of State is asking me, the shadow Secretary of State, whether I am going to consult on her Bill. Now, I am willing to help her out, but if she wants me to sit on that side of the Chamber and run the Department of Health and Social Care, I am ready and willing, but we need a general election to do that. I do not understand—this is just extraordinary. I feel like I am living in a parallel universe this afternoon. It was bad enough when the former Prime Minister, the right hon. Member for South West Norfolk, walked in with her book and her fan club, and now we have the absurd spectacle of the Secretary of State asking me whether I will run the consultation on her Bill. This is extraordinary. I will allow her to correct the record and save her blushes.
Victoria Atkins
The hon. Gentleman is not listening. He has been asked repeatedly whether he supports the concept of a consultation on vaping in order to ensure that these regulations are drawn up properly. He is not listening. He refuses to answer the question. We on this side of the House are clear: we want to get this right and we will consult. I am simply asking whether he will answer the questions that he has been asked.
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.
NHS Consultant Workforce
Victoria Atkins Excerpts(1 week, 5 days ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Victoria Atkins)
I am pleased to confirm to the House that the Government will move to implement the offer made on 5 March to the NHS consultant workforce in England.
Following negotiations with the British Medical Association (BMA) and Hospital Consultants and Specialists Association (HCSA) committees in February, their members have now voted overwhelmingly in favour to accept the revised offer made to them by around 83%.
This result demonstrates that the Government have listened carefully to the concerns of consultants in England, particularly around retention, motivation and morale, and worked closely with the unions to achieve a good outcome for patients, consultants and the taxpayer.
The core contract for consultants has not been updated for 20 years and this deal reforms and modernises the consultants’ pay structure, and will help mitigate the gender pay gap in medicine and improve equalities. The deal builds on the headline pay uplift for 2023-24. Changes to the operation of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) will also be made to address matters raised by the BMA and HCSA.
This deal now ends damaging strike action by consultants that has had a detrimental impact on patients and the NHS and will allow consultants to focus their efforts on cutting waiting times for patients. The overall waiting list has dropped by almost 200,000 in the last five months.
I am also committed to finding a reasonable solution with SAS and junior doctors that ends industrial action. The consultants’ deal is testament to what we can achieve when both parties approach negotiations in good faith and with reasonable expectations.
[HCWS401]
Cass Review
Victoria Atkins Excerpts(1 week, 5 days ago)
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The Secretary of State for Health and Social Care (Victoria Atkins)
With your permission, Madam Deputy Speaker, I would like to make a statement on the Cass review of gender identity services for children and young people. May I say how pleased I am that we are joined by parents of children who have been affected by some of the issues raised in this review? I hope all of us will bear the sensitivities of this debate in mind as we discuss it this afternoon.
This review strikes hard and sure at an area of public policy where fashionable cultural values have overtaken evidence, safety and biological reality. This must now stop. As recently as 2009, the NHS’s sole gender identity development service at the Tavistock and Portman NHS Foundation Trust received fewer than 60 referrals for children and young people, and just 15 for adolescent girls. Since then, demand has surged. By 2016, over 1,700 children and young people a year were referred—a 34-fold increase. More than half were teenage girls. In 2022, more than 5,000 children and young people were referred to gender identity clinics, and almost three quarters were female.
This exponential increase in demand is not a coincidence; it has been driven by a number of factors which I will come to later, but at its heart it was driven by a myth. This myth was that for children and young people grappling with adolescence who were questioning their identity, their sexuality or their path in life, the answer to their questions was inevitably to change gender to solve their feelings of unease, discomfort or distress.
That near-uniform prescription was imposed on children and young people with complex needs without full and thoughtful consideration of their wider needs, including, as is set out in the report, conditions such as neurodiversity, experiences such as childhood trauma or mental health conditions, or indeed discovering who it is that they may one day fall in love with. Indeed, the response from some of the people who should have protected them—some of the clinicians in charge of their care at the Tavistock clinic—was almost always to put them on an irreversible path: blocking puberty, then prescribing cross-sex hormones, and on to surgery as an adult. In other words, such professionals were not asking the right questions of themselves or of their patients.
That is why in 2020, with the support of my predecessors, my right hon. Friends the Members for West Suffolk (Matt Hancock) and for Bromsgrove (Sir Sajid Javid), NHS England commissioned Dr Hilary Cass to examine the state of services for children questioning their gender. I would like to start by thanking Dr Cass and her team for undertaking a considered, comprehensive and courageous review into an extremely contentious area of healthcare. Since NHS England commissioned the review in 2020, they have meticulously unpicked what went wrong, what the evidence really shows and how to design a fundamentally different service that better serves the needs of children.
I must also thank those who raised the alarm and contributed to the review over the last four years: the clinicians who spoke up against their peers to blow the whistle about what was happening at the Tavistock clinic, even though it risked their careers; the journalists, academics and activists who listened to their stories and investigated further, even when they were derided as bigots and transphobes; the parents who were just trying their best to support their children, but were so badly let down by a service that vilified them for questioning whether the interventions offered were right for their children; and, of course, the young people themselves who have shared their experiences, including those who have gone through the pain of de-transitioning only to find out that the so-called “reversible” treatments they were offered are not in fact reversible.
The Cass review makes for sober reading. It is extremely thorough, so I will not attempt to cover all its recommendations today, but I genuinely encourage all Members to read the report in full. It should concern every single Member of this House that part of our public space—the NHS—was overtaken by a culture of secrecy and ideology that was allowed to trump evidence and safety. We say enough is enough; our young people deserve better, and we must do whatever it takes to protect them.
Since the publication of Dr Cass’s interim report in 2022, a series of important changes have been made, and I put on record my thanks to NHS England’s chief executive, Amanda Pritchard, and all those at NHS England who have worked hard with Dr Cass to implement them. On 31 March, the Tavistock clinic finally closed, having stopped seeing new patients a year earlier. Two new regional hubs have been opened, in partnership with the country’s most prestigious children’s hospitals, to ensure that children are supported by specialist, multidisciplinary teams. Indeed, another hub will follow in Bristol later this year.
In the past few weeks, NHS England made the landmark decision to end the routine prescription to children of puberty blockers for gender dysphoria. On the day of publication of Dr Cass’s final report, it announced that it is stopping children under 18 from being seen by adult gender services with immediate effect, and an urgent review on clinical policy for cross-sex hormones will now follow without delay. I also welcome NHS England’s plans to bring forward its full review of adult services, including Dr Cass’s recommendation for a follow-through service for young people up to the age of 25.
I also share Dr Cass’s concerns that clinicians who subscribe to gender ideology will try to use private providers to get around the rules. Let me give a very clear warning: prescribing is a highly regulated activity, and the Care Quality Commission has not licensed any gender clinic to prescribe hormone blockers or cross-sex hormones to people under the age of 16. Any clinic that does may be committing extremely serious regulatory offences for which its licence can be revoked and its clinicians can be struck off. My officials have been in contact with the CQC following the final report to ask that it looks again at the age thresholds in its licensing conditions.
The CQC has also reassured us that it will incorporate Dr Cass’s recommendations into their safe care and treatment standards for all care providers. That means that all new providers will be asked if their practices respect the Cass review, and all existing providers have to meet the same rigorous standards when they are reviewed by the CQC. My officials met the General Medical Council over the weekend, and will do so again in the coming days, to understand how it will ensure that every clinician on its register follows its code of practice and implements the wider findings of the Cass review.
It is morally and medically reprehensible that some online providers not registered in the UK have stated their intention to continue to issue prescriptions to children in this country. I am looking closely at what can be done to curtail any loopholes in prescribing practices, including legislative options. Nothing is off the table, and I will update the House in due course as we progress that work at pace.
Dr Cass also found that there was a lack of robust data on what happened to the 9,000 children who were treated by gender identity services between 2009 and 2020. Many went on to continue their treatment at adult clinics, and the University of York had been due to research the long-term consequences of treatment they received as children, so that we can properly support them through their journey into adulthood. It was expected to provide important insights into the clinic’s work, including how many patients de-transitioned and how many were also diagnosed with a mental health condition or an autism spectrum disorder.
This Government took the unprecedented step of changing the law to make it possible for adult gender clinics to share medical data with the university. All bar one of the adult gender clinics refused to co-operate with this vital research. To quote Dr Cass, that is “unacceptable”, but I would go even further: I think it is deplorable and a dereliction of their professional duty. I am pleased to update the House that following the publication of Dr Cass’s report, I have been informed that all seven clinical leads for the adult gender services now intend to fully participate in this important work.
Dr Cass also concludes that a cultural shift alone “does not adequately explain” the huge growth in young women being referred to gender services. She paints an alarming picture of digitally engaged young women who are frequently exposed to pornography involving violent, coercive, degrading and pain-inducing acts. Is it any wonder than more and more of them are looking for ways to opt out of becoming women? That is deeply troubling and, as Dr Cass makes clear, we have a duty to support those young women with considered, evidence-based care.
Our children deserve healthcare that is compassionate, caring and careful. Their safety and wellbeing must come above any other concern, and anyone who threatens it must be held to account. I will work with NHS England to root out the ideology that has caused so much unnecessary harm, to support those who have already received life-altering treatment, to give the next generation access to holistic care, and to protect our children’s futures. Anything less would be neglecting our duty to the next generation. That will not happen under this Government, and it will not happen under my watch.
Madam Deputy Speaker (Dame Rosie Winterton)
I call the shadow Secretary of State.
Wes Streeting (Ilford North) (Lab)
I thank the Secretary of State for advance sight of her statement and, even more importantly, Dr Hilary Cass and her team for the thoughtful and thorough way in which they have undertaken their work. Dr Cass has navigated the complexities and sensitivities of the subject with academic rigour, providing an evidence-led framework for children to receive the best possible healthcare. I also pay tribute to journalists such as Hannah Barnes and the whistleblowers who together helped to shine a light on what was going on at the Tavistock clinic.
At the heart of the complexity around this issue are two things that are true simultaneously. There are trans adults in this country who have followed a medical pathway and who say that, for all the pain and difficulty that involved, it was not just life-affirming; it was lifesaving. There are also people in this country who followed a medical pathway but who say it was a disaster that ruined their lives irreversibly, and they ask how anyone could have let that happen. For the sake of all those children, young people and now adults—but particularly those being referred into gender identity services today—we have a duty to get this right.
What has emerged in the Cass review is a scandal. It is a scandal that children and young people are waiting far too long—often years—for care while their wellbeing deteriorates and their childhood slips away. It is scandalous that medical interventions have been made on the basis of shaky evidence. It is scandalous that, despite all that, some NHS providers refused to co-operate with Dr Cass’s review. Perhaps the worst scandal of all is that the toxicity of this discussion means that people have felt silenced, and it required investigative journalism to prompt the review to take place. This particularly vulnerable group of children and young people are at the wrong end of all the statistics for mental ill health, suicide and self-harm. There is no doubt that they have been very badly let down, so we owe it to them to approach this discussion with the same care and sensitivity with which Dr Cass undertook her review.
Parts of the report will sound familiar to anyone acquainted with the NHS today. Children and young people face unacceptably long waiting lists and are unable to get the mental health support and assessments they require, and services face significant staff shortages, with a lack of workforce planning driving all of that. As with so many parts of the NHS today, the report paints a picture of a service unable to cope with demand. Dr Cass is clear that care must be personal and holistic. Will the Secretary of State set out how she plans to cut waiting times for assessments for mental health and neurodevelopmental conditions?
Waiting lists are so bad in some cases that children are passing into adulthood before they have had their first appointment with gender identity services, leaving them facing a cliff edge. Cass recommends follow-through services up to the age of 25 to ensure continuity of care. Will the Secretary of State indicate how long she thinks it will take to establish those services?
Labour welcomed the decision by NHS England last month to stop the routine prescription of puberty blockers to under-18s. The loophole that exists for private providers risks sparking a black market. The Secretary of State has said that she expects private clinics to follow the report’s recommendations to follow the evidence. I underline our support for her expectations on compliance. Can she give an indication of whether she thinks that further regulation may be needed to ensure adequate enforcement of the recommendations?
The refusal of adult gender services to share data on the long-term experience of patients is inexcusable—as the Secretary of State said, it is deplorable. The data does not belong to them; it belongs to the NHS and, crucially, to patients. I welcome their coming forward now, but how was this allowed to happen, and what accountability does she think would be appropriate?
This report must provide a watershed moment for the NHS’s gender identity services. Children’s healthcare should always be led by evidence and be in the best interests of children’s welfare. Dr Cass’s report has provided the basis on which to go forward. The report must also provide a watershed moment for the way in which our society and our politics discuss this issue. There are children, young people and adults—including trans children, young people and adults—in this country who are desperately worried and frightened by the toxicity of this debate. There are healthcare professionals who are scared to do their job and make their views known. Dr Cass said that
“toxic, ideological and polarised public debate has made the work of the Review significantly harder”
and it will hamper the research that is essential to finding a way forward.
Even in a general election year, there is surely one issue on which we can down tools and work together: the pursuit of the healthcare of vulnerable people. I pay tribute to the right hon. Member for Bromsgrove (Sir Sajid Javid). We had many scraps across the Dispatch Box, but for his role in commissioning this review he deserves our thanks and respect. I hope to work constructively with the Health Secretary to put children’s health and wellbeing above the political fray.
Victoria Atkins
I welcome all those who have changed their minds about this critical issue. In order to move forward and get on with the vital work that Dr Cass recommends, we need more people to face up to the truth, no matter how uncomfortable that makes them feel. I hope the hon. Gentleman has the humility to understand that the ideology that he and his colleagues espoused was part of the problem. He talked about the culture and the toxicity of the debate. Does he understand the hurt that he caused to people when he told them to “just get over it”? Does he know that when he and his friends on the left spent the last decade crying, “Culture wars,” when legitimate concerns were raised created an atmosphere of intimidation, with the impact on the workforce that he rightly described? People were scared or worried to go into it.
Does the hon. Gentleman now have the good grace to apologise to those who have been maligned in public life—including his own female colleagues—and for the chilling effect that this has had on clinicians, journalists and campaigners who were trying to raise the alarm? I say that because I want to believe the hon. Gentleman when he says that he has turned a corner on this issue. We have to start with a new page, for the sake not just of the children and young people we are looking after but of their families, many of whom will be watching this, living with the consequences of the ideology and secrecy, wondering how on earth the hon. Gentleman talks about general elections when, every single minute and day, their children have to live with treatment that can never be reversed.
Dame Jackie Doyle-Price (Thurrock) (Con)
The report is very welcome, but it has been a long time coming. One issue I would like to put to my right hon. Friend is the whole failure of governance that it shows. In particular, NHS England’s specialist commissioning requires challenge. As she explained, what was initially commissioned as a treatment course for a small minority of people has been allowed to expand unchecked and without any consideration of the ethics of what was being done to children. What will she do to ensure that does not happen again? Secondly, the Tavistock clearly enjoyed the popularity brought by being at the front end of what was seen as a set of cutting-edge treatments. Frankly, the governors allowed that to get in the way of what they should have been doing: ensuring patient safety. What does she propose to do about that as well?
Victoria Atkins
I thank my hon. Friend, who in her parliamentary career has done so much to shine a light on this sort of behaviour. She has espoused worries, both publicly and privately, about the children and young people at the heart of this matter. Looking to the future, the Tavistock clinic has shut. As I said, it stopped admitting patients a year ago. The new services that are already in place—the two new hubs, with plans to expand further across the country—are about ensuring a multidisciplinary approach to young people, so that, with exactly the experiences Dr Cass sets outs so starkly in her report, children are treated as human beings and patients, not as siloed conditions. One of the main problems that emerged with the Tavistock behaviour and the way it took place is that gender questioning was siloed in a way that no other health or mental health condition was. We want to move back to a place where clinicians are no longer scared of looking after children and young people with these issues, and that they see it as part of their general practice and general work. That is how we are best going to address the very complex needs of many of these children and young people.
Kirsten Oswald (East Renfrewshire) (SNP)
I am grateful for advance sight of the statement.
Nobody’s identity should be up for debate, and nor should it be used as a political football. Dr Cass said in her report:
“Polarisation and stifling of debate do nothing to help the young people caught in the middle of a stormy social discourse, and in the long run will also hamper the research that is essential to finding the best way of supporting them to thrive.”
That polarisation is the last thing needed by young people in accessing care, their families and the NHS staff working hard to care for them. Does the Secretary of State agree that we must all remain respectful at all times when discussing these important issues, and that decisions on this and any other type of treatment should rightly be made by clinicians, not politicians?
Dr Cass explicitly makes the point that her report is not about questioning trans identities or rolling back access to healthcare for young trans people. Indeed, supporting and improving the gender identity healthcare system for all, including children and young people, is what we should be focused on. So can the Secretary of State confirm today whether any additional funding will be made available to ensure that young trans people can access the quality healthcare they need and deserve?
Finally, on conversion practices, the Government Equalities Office said last month in an answer to a written question:
“The Government expects to deliver a draft Bill that takes account of the independent Cass review”.
Can the Secretary of State provide an update on what conversations she has had with Cabinet colleagues on how the Cass review will influence the UK Government’s legislative proposals on banning conversion practices, and when can we expect them to be published?
Victoria Atkins
I encourage both the Scottish National party in Scotland and Labour in Wales—health is devolved in those countries, of course—to respond as quickly as possible to the findings of the review. The hon. Lady asks whether it is Barnett-ised. For these purposes, our work to ensure that the clinics meet the needs of our population in England is not additional money. We are re-prioritising within NHS budgets to ensure that the services are spread across the country. I encourage the Scottish nationalists to prioritise the needs of their children and young people in the same way.
I would also gently make the point that, when it comes to the atmosphere of this debate, I do not believe it has been helped by the SNP’s highly controversial Hate Crime and Public Order (Scotland) Act 2021. I note, for example, the behaviour and engagement on Twitter of very high-profile people in Scotland, and the impact that it has had when people have dared to name activists in this arena. I would also ask the Scottish Labour party to explain why it helped the SNP to pass that Act, because to me this seems to be all about the atmosphere.
Madam Deputy Speaker (Dame Rosie Winterton)
I call the Chair of the Women and Equalities Committee.
Caroline Nokes (Romsey and Southampton North) (Con)
Dr Cass’s observations about violent and degrading pornography are chilling, and we know of the impact that is having not just on young girls but on all our young people. Her recommendations also include significant and specific references to expanded services and follow-through services for 17 to 25-year-olds. What concerns has my right hon. Friend about the capacity for that, and about the possible impact on other areas of healthcare?
We know that the transition from children’s services to adult services can be problematic in the case of a wide range of services, not least for those suffering from body dysmorphia or eating disorders. Might there be any crossover, with young people having access to some sort of interim service before the age of 25, and will more funds be committed so that we do not continue to see what all of us will face in our constituencies: the horror of young people being unable to access child and adolescent mental health services before they turn 18 and become reliant on adult mental health care?
Victoria Atkins
My right hon. Friend is right to identify the cohort of young people between the ages of 17 and 25 as being of particular concern. Now that we have a clear pathway in relation to the treatment of children and young people under the age of 17, I have asked NHSE to focus primarily on that next cohort. Speaking to parents gives one a very real sense of their concerns about what they describe as the cliff edge between children and young people’s services and adult services for this very vulnerable group of young people. I do not want that to continue, and over the coming months we will see NHSE develop work to help that cohort.
My right hon. Friend has an understanding not just of how transformational the report and its evidence are, but of the challenges that this means for our health service in England and how we choose to respond. As for funding, NHSE has committed more than £17 million to the two new hubs in the current financial year, and I hope and expect that our devolved Administrations will commit similar sums to looking after children and young people in their areas.
Dame Nia Griffith (Llanelli) (Lab)
The Secretary of State has spoken of the need for multi-site centres, and has pointed out that two hubs have already been established. Will she tell us a little more about her plans to expand this to make it multi-site, and when that is likely to happen?
Victoria Atkins
As I have said, we hope to expand it to Bristol later in the year, and there will be a further three or four sites across England. However—this is a really important part of the report—this is not just about specialist services but about giving clinicians the necessary confidence to look after children and young people who may well be presenting at their clinics or surgeries with this condition as one of a number of conditions. We want to give them back that confidence, and the comfort of knowing that they need not just go down the narrow pathway of specialist services. Of course that will be appropriate for many, but we want to treat the whole child rather than treating just this particular condition, as has happened in the past.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I must first declare my interest as a practising NHS consultant paediatrician whose practice sometimes involves caring for children with the condition we have been describing.
The Cass Review makes for sobering reading. This is an example of ideology being allowed to trump evidence and safeguarding. Let me give the Secretary of State a specific example. Individuals have thwarted the attempts of those working on the report to conduct research that would give them a better understanding of the outcomes for some children. I am pleased to hear that those people are now co-operating, but we should note the contents of a letter from John Stewart, the national director of specialised commissioning, which is appended to the report. He says that although NHS England wrote to the chief executives and medical directors of all NHS trusts, the research data was not released. One of the duties of doctors that are specified by the General Medical Council is to
“Engage with colleagues to maintain and improve the safety and quality of…care.”
May I ask the Secretary of State who exactly blocked that data, what investigations will be carried out to find out which individuals were responsible, and how they will individually be held accountable for their actions? How was it possible for them to do this in the first place, and what is she doing to ensure that data cannot be blocked in the same way in the future?
Victoria Atkins
I am extremely grateful to my hon. Friend for bringing her clinical expertise and experience to the Chamber and to this important debate. As for her precise questions about who did what and when, I hope she will understand that I have been working at pace on this report over the last few days; I have asked these questions myself, and I will update the House when I am in a position to do so.
Let me return the House’s attention to the expectation, not just moral but professional—in the light of the report and the evidence that it has produced—that clinicians and other medical professionals will act in accordance with these recommendations. That will mean that when regulators examine the conduct of medical professionals, they do so against this backdrop and in the context of these expectations. If there are people who are operating under the misguided apprehension that their ideology trumps the evidence, I fully expect the regulators to crack down on that.
Several hon. Members rose—
Rosie Duffield (Canterbury) (Lab)
Let me first thank the Secretary of State for her thoughtful and considered statement on the Cass review, and especially for mentioning the journalists, such as my friend Hannah Barnes, who blew the whistle on the Tavistock clinic. As she has said, those who have raised this issue over the last few years, desperately concerned about the safeguarding of vulnerable children and young people—too young to make life-changing decisions—are owed a heartfelt apology for being no-platformed, ghosted, sidelined and disciplined at the behest of a few extreme groups of activists, some within political parties. Does she agree that these academics, politicians, writers, psychologists and actors, along with any other people who have questioned the signing up of their workplaces to Stonewall law, have now been vindicated by Dr Cass’s expert review, and that they should be apologised to?
Victoria Atkins
I come to the Dispatch Box with huge admiration for the hon. Lady for the commitment that she and other Labour Back Benchers have shown, in a culture and an atmosphere in which their views were demeaned and they were sneered at and castigated. Indeed, I hear rumours that efforts were made to remove certain Members from the party itself. This is the moment for apologies and for humility, but also for us to start a clean page and ensure that, when perfectly reasonable questions are asked about the medical treatment of our children, those questions are allowed to be asked in an atmosphere of respect and understanding, so that these vulnerable children and young people are looked after in a caring and careful way.
Miriam Cates (Penistone and Stocksbridge) (Con)
I warmly welcome the Cass review and its findings, and the extraordinarily strong statement made by my right hon. Friend. I have no doubt that what happened at GIDS—the Gender Identity Development Service—will go down as one of the worst safeguarding and medical scandals of our generation. I pay tribute to the brave parents, including those in the Bayswater support group, who have been raising concerns for years about the ethics and the safety of putting vulnerable children on irreversible and unevidenced medical pathways with the aim of achieving something that can never be achieved, which is to change their sex. Those who spoke up for the interests of children and, frankly, for the interests of common sense were labelled bigots, transphobes and even fascists. Even after concerns were raised and Dr Cass had been commissioned, the Tavistock was allowed to continue to practise, which was a shocking suspension of the precautionary principle. This scandal happened because too many adults put their own desire for social approval above the safety of vulnerable children. How can we make sure that that does not happen again?
Victoria Atkins
As my hon. Friend was asking that question, there were people on the Opposition Benches tutting her. That shows that while some understand the need to keep the debate about the clinical needs of these children and compassion, there are still people on the Opposition Benches who do not get it. For example, in 2020 the deputy leader of the Labour party signed a charter describing bodies such as Woman’s Place UK, which, dare I say, campaigns for single-sex rape refuges—to which the House knows I have an enormous commitment—as “trans-exclusionist hate groups”. That sort of language needs to be apologised for, so that we can all move on. We expect clinicians and medical professionals to do the right thing by the Cass report, and by our children and young people. There needs to be some leadership from all of us in public life to ensure that we set the right example to those people.
Christine Jardine (Edinburgh West) (LD)
At its heart, the Cass report sadly highlights the low standard of care for our young people who were caught up in a toxic debate. There were long waiting lists, and the debate seeped into the staffing of the medical profession. Does the Secretary of State agree that we have to look at the wellbeing of our children holistically? How will she overcome the recruitment and staffing problems that have been created by this toxic debate?
Victoria Atkins
I thank the hon. Lady, who has an exemplary record of campaigning on this issue. This comes down to the very careful review by Dr Cass. We have to get away from the idea that if a child presents with gender distress, that is the only part of their health that we should care about and look into. We have to look across the board to ensure that we look after every single part of them and do not assume that medical pathways are the only and inevitable pathways for them. One of the concerns raised in the report is that the terrible mental health issues that many children and young people were suffering from were not being looked after. People were just put on drugs and expected to get on with it. That is wrong, and we are determined to change it.
Paul Bristow (Peterborough) (Con)
What was the Secretary of State’s reaction to the news that almost all gender clinics refused to co-operate with the Cass review? Does she agree that this is too important an issue for a circle-the-wagons attitude? What can she do to ensure that Government guidance is followed to the letter, and in spirit, when we tackle a gender ideology that seems to be running rampant through our public institutions?
Victoria Atkins
This is not about my emotions, but I can tell my hon. Friend that I was disgusted and angry. What is more, this is about being able to have conversations in our public space. For example, if our public institutions—whether it is the NHS, schools or whatever—are asked to respond to a thoughtful and careful review such as the Cass report, they must do so, because this information does not belong to them; it belongs to their patients, to future patients—because we want to shape services to help them—and to us as a nation. I welcome such institutions’ about-turn in deciding that they will provide the data. I am pleased that has happened, but my goodness me, I wish they had done it earlier.
Dawn Butler (Brent Central) (Lab)
All trans children and young people deserve access to high-quality and timely healthcare and support. Around 100 studies have not been included in the Cass report, and we need to know why. The Secretary of State is obviously not concerned about the way that the Cass report has been used to perpetuate a broader hostile environment towards trans people in the UK—a hostile environment created in part by the Government’s delay in reforming the Gender Recognition Act 2004. Misrepresenting the report, and the high-and-mighty attitude from the Secretary of State, helps no one. Will she commit to the extra funding needed to help young people have a holistic approach to their healthcare pathway?
Victoria Atkins
I am not clear whether the hon. Lady supports the report or is castigating it; I have no idea whether she supports it or not. We are trying to use the evidence in this very thorough and thoughtful review, in the words of her Front-Bench spokesman, to help clinicians treat our young people and children in a compassionate, caring way. I have noticed, and have had it reported to me by others who have been watching, that certain campaigners are trying to build up a head of steam to say that the report is somehow flawed. It is not. This is superb evidence, and the NHS has assured us that it will act on it.
Jason McCartney (Colne Valley) (Con)
The Cass review highlights the deterioration of mental health in young people. It particularly highlights the impact of social media, which puts awful pressures on young people. The mental health crisis obviously affects both boys and girls, but as the Secretary of State highlighted earlier, it particularly affects girls and young women. Will she continue to turbocharge child and adolescent mental health services’ crisis teams, and give them the resources that they desperately need to support our young people?
Victoria Atkins
I thank my hon. Friend for his question. We want to not just help with crisis support, but prevent our young people from getting into a position of crisis in the first place, so we are rolling out mental health support teams, ahead of our schedule, across schools. That is a really important piece of work that will help 44% of the student population, but we want to go even further. In the 12-month period ending in March 2021, we increased the number of children and young people aged under 18 who received NHS-funded mental health services to some 758,000. Of course, we want that support to be there in the community, but importantly we also want to help clinicians to understand that this is just one of several sets of conditions that they should have confidence to work on, in order to look after the child holistically.
Sammy Wilson (East Antrim) (DUP)
Given the vile campaigns directed towards anyone who disagrees with the transgender lobby, we should congratulate Dr Cass and her team on having the courage to write their report, and the Secretary of State on her robust defence of it. In the light of the report, and given that it seems that the transgender lobby has infiltrated the NHS in England, what steps is she taking to purge that lobby from the NHS? What discussions has she had with Ministers in Northern Ireland, Scotland and Wales to ensure that the same policies and practices are not carried out in the public and private sectors there?
Victoria Atkins
The reason why I am able to be so robust on this issue is that I believe in it; on that, I may be different from others. The challenge that the right hon. Gentleman rightly puts forward is that we have to ensure that NHS England acts as an organisation, but also at the individual and local levels, to implement the reforms that the report recommends. I want to be fair to clinicians, medical professionals, managers and others who very much support the review. I want to support them in taking up the recommendations. What individual clinicians may or may not have done in the past will be a matter for both NHS England and the regulators going forward. The moral and professional expectation is that in future, clinicians, medical professionals and all of us will respect the evidence and the recommendations of this important report.
Angela Richardson (Guildford) (Con)
I would like to put on the record my thanks to Dr Hilary Cass for her thoughtful and comprehensive review. Does my right hon. Friend agree that those of us across this House who, for the past few years, have been calling for a pause on the ban on conversion therapy while we wait for Cass, because of concerns not with the L, G or B, but the T element of the ban on LGBT conversion therapy, have been completely vindicated in that call?
Victoria Atkins
I thank my hon. Friend sincerely for her help in raising these difficult questions and for doing so, as she has just demonstrated, in a thoughtful and careful manner. I know that she shares my concern that the children and young people at the heart of this should be our focus. We need to build the system around them, rather than them being slotted into the system, as has happened in the past.
On conversion therapy—again, I am being very mindful of the sensitivities of this—we are committed to supporting all victims of conversion practices, but we want to avoid any unintended consequences and ensure that the draft Bill takes account of the independent Cass review. That is why my Cabinet counterpart, the Minister for Women and Equalities, is leading the work in this area. We are very much considering this complex issue as part of our approach to this sensitive and important matter.
Tonia Antoniazzi (Gower) (Lab)
The starting point of all modern medicine must be robust and reliable—in fact, rigorous—evidence. Back in 2017, I tabled a written question at the request of a trans constituent who was concerned that many adults and young people were putting themselves through a process that was not the right one for them. That was in 2017, and we still do not have much better data, but the data is the most important thing; it informs everything.
There has been a chilling effect in this Chamber, and on social media, on people who have spoken out, and who have asked questions like that—questions that we ask for reasons to do with everyday healthcare, which we have denied, and the Government have denied, to the children in our care. My hon. Friend the Member for Ilford North (Wes Streeting) has been fantastic; he has shown great maturity and reflection in his comments in the Chamber and in the media, and so has the Secretary of State, but as someone who has been at the other end of this, I say: please, Secretary of State, let us get the tone of this debate right, and move forward. The Cass report is a great thing, and we have to work with it to deliver the best outcomes for the children in our care.
Victoria Atkins
Again, I approach the Dispatch Box with humility because I know about the journey that the hon. Lady has been on, and about the debates and questions that she has brought forward, not just on behalf of the constituent that she mentions, but on the wider issue of the treatment of women in healthcare and in other parts of public life. I very much want us to view the future as a clean sheet, so that we can build services around children, rather than expecting them to slot into services for the convenience of arguments that were put forward in the past.
However, we have to acknowledge that this has been such a long and toxic debate that there will be people who want answers. I appreciate the fact that the hon. Member for Ilford North (Wes Streeting) has walked back some of his comments, but it is important that we acknowledge the toxicity, so that we can move on and achieve exactly what the hon. Lady and I, and others around the Chamber, seek. [Interruption.] Interestingly, Opposition Members are chuntering from sedentary positions. I think that we can make a real change, but a little less sniping from the sidelines and a little more constructive work is needed.
Nick Fletcher (Don Valley) (Con)
I have called out this ideology locally, and here in Westminster with colleagues, at every opportunity available to me. At last, it appears that the world is waking up to this issue. Sadly, we know of at least 9,000 children who have been affected by this scandal and possibly damaged for life, so first I ask the Secretary of State whether she will establish a public inquiry into this issue.
Secondly, alongside reforms to the NHS, we must re-establish safeguarding in schools. Will the Secretary of State liaise with her Education colleagues to fix our statutory safeguarding guidance keeping children safe in education? It currently downplays the risk factor around a child identifying as trans; that must be addressed.
Finally, I believe that there are many bad actors who have peddled this nonsense, clearly knowing what they were doing while destroying our young people’s lives. If there is any justice, those individuals should feel the full weight of the law. I hope that they are quaking in their boots. They ought to be.
Victoria Atkins
I thank my hon. Friend for his powerful question. I am going to deal, if I may, with his point about a public inquiry, because I know that there are some who are asking whether that would be appropriate. Will my hon. Friend take it from me that, at the moment—bearing in mind that the report landed less than a week ago—I am determined to drive forward the actions that are needed on the ground to help children and young people? We have had a four-year review into this—Dr Cass has gathered a great deal of evidence and it is a very thorough review—and so, for the moment, I want to concentrate on implementing the recommendations and on ensuring that the services are brought up to the standards that my hon. Friend rightly understands.
On my hon. Friend’s second point, of course I will liaise with my colleagues in the Department for Education. This is about helping all public sector professionals to ensure that they are acting on the evidence, as set out in the Cass review, for the sake of our children and young people.
Joanna Cherry (Edinburgh South West) (SNP)
I warmly welcome this statement; that is not something that the Secretary of State will often hear from me. As she said, the Cass report has vindicated the concerns of many whistleblowers, including feminists and LGB activists, who warned of the consequences for children of unevidenced medical interventions and the ideological capture of the NHS. For doing so, we—because I was part of this—were defamed and hounded by organisations that many of us had formerly supported, like Stonewall, Mermaids, PinkNews, which I had to sue for defamation, and the misnamed Equality Network in Scotland. To their shame, Members of this House and Members of the other place joined in with that bullying and group-think.
While I hear what the Secretary of State has to say about a public inquiry, and about her immediate focus being on implementing the recommendations, it seems to me that we do need a public inquiry into how this institutional capture happened in our public bodies—as we all know, it is not just the NHS—because we need to make sure that never again do ideologues of any sort, or science deniers, take hold of our public institutions. When the Secretary of State is done with implementing the recommendations, or as she is doing that, will she support the movement for a public inquiry into these matters?
Victoria Atkins
I am conscious that I have just answered that, but may I put on the record my thanks and respect for everything that the hon. and learned Lady has done in this field? She has at times had to walk a very, very lonely path, and I find it extraordinary that parliamentarians—who are elected to represent the best interests of our constituents, and indeed of our countries—would find themselves under that sort of pressure for simply stating biological fact. I hope that the hon. and learned Lady will be working with me to ensure that the recommendations in the Cass review are applied not just in England but in Scotland, in Wales and in Northern Ireland.
Steve Double (St Austell and Newquay) (Con)
I very much welcome this report and the strong statement by the Secretary of State in response to it. If there is one thing that should be above party politics, above political ideology, and above cultural trends or virtue signalling, it is the welfare of our young people, and this report lays bare that, sadly, that is exactly what has not been happening. This ideology has not only captured part of our NHS; it is found in many of our public sector institutions. I ask the Secretary of State, who has clearly taken a strong leadership position on the matter today, whether she will ensure that the findings of this report are implemented across Government—in education, local government, social services, and in our police force—to ensure that this can never happen again?
Victoria Atkins
This report sets out the evidence, which was not there before. It has taken four long years of very hard work to gather that evidence, and I hope and expect that the health sector will implement these recommendations. I also hope we can have a conversation about our wider public space, and I was very pleased to read the article by my right hon. Friend the Minister for Women and Equalities over the weekend. We have to de-politicise the public space and ensure that this evidence is applied across the board for the health of all our constituents and our country.
Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)
I welcome any research, and this report moves the debate forward. My reading is that Cass says there is a toxic debate on all sides, and that there are particularly nasty and vicious people on all sides. I have had posters put outside my house with rude words on them, etc, and it has happened on all sides. That is what Cass says—that it is unhelpful.
Cass says there seems to be little evidence that large numbers of people feel either regret or success, that there is poor evidence of effectiveness, and that there needs to be more evidence on the usefulness of social transition. I read it as saying that there needs to be an awful lot more evidence, but Cass is clear that young people should not be denied access to healthcare if they are trans; in fact, they should have more healthcare and more pathways. Will the Minister agree to fund that research? We should not get evidence from just adult services. We need proper longitudinal studies that mean we have an evidence base. Will the Government support a Cass-compliant amendment to my Conversion Practices (Prohibition) Bill that I believe can square this circle?
Victoria Atkins
I am sorry, but I think there is a certain amount of disbelief in the Chamber. I cannot be the only one who remembers the debate on the Gender Recognition Reform (Scotland) Bill in January 2023 when the hon. Gentleman not only tried to shout down female Opposition colleagues but felt so exercised that he crossed the Floor of the House to sit next to my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates). I remember how Conservative Members were genuinely surprised that a Member of Parliament would think it appropriate to behave in that way when debating a subject that we are entitled to, and should feel free to, debate. I am sorry to hear that the hon. Gentleman suffered the abuse that he describes, but setting a good example starts at home. I hope he will never again behave as he did in the Chamber that day, because that is how we sort out the toxicity of this debate.
Douglas Ross (Moray) (Con)
The Scottish Government’s response to the Cass review has been one of deafening silence. In fact, SNP Ministers have buried their heads in the sand and said nothing proactively about the review or its conclusions and recommendations. Indeed, the Scottish Conservatives’ request to have a statement in the Scottish Parliament on the Cass review has so far been refused by the SNP-Green Government, so I welcome the opportunity to speak about it here in the UK Parliament.
In her statement, the Secretary of State mentioned NHS England’s recent decision to end the routine prescription of puberty blockers to children. However, they are still available in Scotland. What discussions have there been on this issue, if any, between Scottish Government Ministers and the UK Government, or indeed between officials in NHS Scotland and NHS England?
Victoria Atkins
I thank my hon. Friend for his careful and considered question. I very much hope that the Scottish National party Government will look at the evidence very carefully and find the recommendations to their liking. It is to NHS England’s credit that it has acted so promptly, and I would hope and expect that the devolved nations, let by the Scottish National party and the Welsh Labour party, will follow with similar speed.
As I have had to say, because it is in line with the atmosphere in which clinicians are having to operate, the Hate Crime and Public Order (Scotland) Act 2021, brought forward by the Scottish National party Government and supported by Scottish Labour, cannot help the considered debate that we wish to have about this very complex subject, and I encourage them to look at that as part of their overall approach.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
I welcome the Cass review and its recommendations. Mistakes have been made that must never happen again, but the polarised public debate that she mentions reflects badly on this House. Does the Minister agree that making jokes about trans people and trans children is cruel, cheapens the debate and moves the focus away from ensuring that all our young people get the help they need when they need it?
Victoria Atkins
True leadership is not just about being careful with the words we use. I will not recite the many words that other Labour Members have used about trans issues. They say, for example, that it is factually inaccurate to say that only women have a cervix—[Interruption.] I am not naming them, but that seems an extraordinary things for a Labour Member to say. [Interruption.] They do not like to hear their words repeated back to them, but I will resist that temptation and instead focus on the application of policy.
Trans prisoners, including those who are fully intact and have been convicted of serious sexual offences, are demanding to be held in prisons that match their chosen gender. This Government, including me and many of my predecessors as Prisons Minister, set clear rules to ensure that situations such as the Karen White case are not repeated, so it was very troubling that Opposition Members did not appear to have the same concerns when it came to the placing of a trans double rapist, Isla Bryson, in Scotland. [Interruption.] I am being told that it is not true but, if Opposition Members want to factcheck, apparently it was the deputy leader of the Labour party who said that it does not matter.
Sir William Cash (Stone) (Con)
Although I would like to believe that many of these problems will be resolved by guidance and by changing the administrative rules, and things of that kind, I fear that the real problem is much deeper. It is about the manner in which, over the last generation, we have introduced legislation that has facilitated these arrangements. I am glad that the Government have passed the Online Safety Act 2023 to deal with the platforms on which a lot of this stuff has been spuriously put out by people with absolutely no moral compass.
I thank the Secretary of State for what she has said this afternoon, and for the robust and extremely effective manner in which she has said it, but please do not believe that this will be resolved just by changes to administrative rules. This is about a moral compass and telling the truth. The legislation, whether it is the Equality Act 2010, human rights law or whatever else it might be, will need to be changed.
Madam Deputy Speaker (Dame Rosie Winterton)
Order. I want to get everyone in, but we really cannot have mini-speeches. We need questions that the Secretary of State can answer briefly.
Victoria Atkins
The brevity of my answer demonstrates my respect for the observations and experience of my hon. Friend the Member for Stone (Sir William Cash). I completely agree with him, and I will enjoy working with him on this.
Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)
I thank the Secretary of State for her very important statement. I welcome every word of it, just as I welcome the final report of the Cass review. I thank Dr Hilary Cass for her outstanding work in lifting the lid on this dangerous ideology and its impact on predominantly young LGB people, and other gender non-conforming young people.
The Secretary of State made an important point about the insinuation of gender ideology and its impact on the health service. As other Members have said, we know that gender ideology has insinuated itself into many of our public bodies and into debate in this place. Pieces of legislation are being proposed in this place that would enforce the very conditions in the Cass report, where gender non-conforming young people are denied proper psychological and psychosocial support to come to a reasonable discussion and end point. What support will the Secretary of State provide to have that conversation and to weed out this ideology elsewhere?
Victoria Atkins
I thank the hon. Gentleman for his advocacy on this issue. I very much hope that all Members will be able to use the evidence produced in this review and report in future debates about legislation so that we can all make informed and correct decisions.
Lia Nici (Great Grimsby) (Con)
Let’s be honest, Secretary of State, this excellent review exposes institutionalised grooming and abuse by so-called “professional” medical people. What is she going to do to make sure that people pushing this from day one are, as a minimum, now going to be on the sex offenders list and taken off being able to practise as medical people?
Victoria Atkins
I thank my hon. Friend and near neighbour for that. She is right, as is my hon. Friend the Member for Stone (Sir William Cash), to emphasise that this is about not just the debate within the NHS, but what happens online. I know that parents of children affected by this are very aware of the online “grooming”, as they describe it, of children on social media. I do not want to trespass for the time being on the regulators—we have already had some constructive conversations with them—but the will of the House is clear that we expect the report to be followed and clinicians to act on the basis of that evidence.
Marsha De Cordova (Battersea) (Lab)
Let me start by saying that I welcome the Cass review’s findings, which make it clear that clinical services must be led by good-quality, robust evidence and highlight the lack and the poor quality of data. We all know the important role that data plays in delivering for patients. So does the Secretary of State agree that the review of adult gender services should take into account the number of patients with mental health challenges, such as depression, anxiety, autism, self-harm, eating disorders and many others? What additional resources will be put in place for mental health provision?
Victoria Atkins
I thank the hon. Lady for her thoughtful question, because she rightly lists some of the mental health conditions that both Dr Cass and professionals in this area have realised can be part of the complex needs of children and young people who are asking questions of their identity and about their path in life. On funding, the financial value of the contract last year with the Tavistock was £9.3 million, but for this financial year NHS England has committed some £17.1 million for the two new hubs for gender services. Of course, they will keep this under review as we build up the services across the country in the ways envisaged in the report.
Richard Fuller (North East Bedfordshire) (Con)
Let me add my thanks to Dr Hilary Cass for her review. Having listened to this Secretary of State today, I am confident that young people in this situation are in safe hands as she implements the recommendations. However, I wish to ask her about accountability, because what we have seen in the NHS with previous scandals, be it the contaminated blood scandal or Mid Staffordshire, is that accountability is a little slippery. Accountability is not just about lessons being learnt; it is about people being held to account for what they have done. So will my right hon. Friend be looking at ways in which there is room for people to be struck off if found to be wrong, for managers to be sacked and, in certain circumstances, for legal action to be taken?
Victoria Atkins
I completely understand my hon. Friend’s desire for accountability. I just remind us all that some clinicians have acted in a morally exemplary way, trying to blow the whistle on practices they observe. He and I, and, I hope, others, want to ensure that clinicians who have not acted in accordance with their professional duties are held to account. As I say, ongoing conversations are taking place with the independent regulators, but I suspect that they have very much understood the way in which the House is viewing this and the seriousness with which we view clinicians who have not abided by their professional duties in this regard.
Kim Johnson (Liverpool, Riverside) (Lab)
Many of the Cass review recommendations are to be welcomed, but there has been some dangerous misinterpretation of some of the recommendations in public discourse and, crucially, in NHS England’s response to the recommendations for transitional services for 17 to 25-year-olds. So will the Minister join me in challenging the NHS specialised commissioning team on its immediate limiting of access to support for 17-year-olds, including with the cancellation of appointments for some who have waited years, and in calling on it to immediately reinstate access while it reviews next steps?
Victoria Atkins
I hope the hon. Lady will forgive me if I have misunderstood her question, but I think she is referring to the decision that NHS England will prevent under-18s from accessing adult gender services. A consultation has just closed and we are looking at the results of that, but I am very sensitive to the needs of young people within that 17-to-25 cohort for whom the “cliff edge”, as it has been described to me, of moving from children’s services to adult services may not be in their best interests. I promise that that is very much the focus of my work on this in the weeks ahead.
Julie Marson (Hertford and Stortford) (Con)
My experience of speaking to my constituents on this subject has been characterised by fear—it is often the fear of mothers about their daughters, the fear of what is happening to their children and the fear of speaking out because of the group-think and the toxicity of the debate. Does my right hon. Friend agree that Dr Cass’s extensive, evidence-based report should mark an absolute turning point, in ensuring that we spearhead our approach to this debate by putting children first and being non-ideological in all areas—across Government, in all Departments, not just the NHS, in education and in our public bodies?
Victoria Atkins
I thank my hon. Friend sincerely for that. Again, she articulates the concerns of many families where a teenager or young person may be suffering complex needs and are asking questions of themselves and their place in society. We must treat not just the child or young person, but the family with care and respect, trying to support them to get to the right place for the child.
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
Some constituents who have contacted me see in the Cass report a vindication of their long-held views on sex and gender following years of abuse, sometimes violent. Others who have contacted me fear that the Cass review represents an attack on their very existence as trans people and fear the abuse to come. Will the Secretary of State set out that she opposes utterly the toxification and politicisation of questions of sex and gender? Will she also set out that she will collect the additional evidence that the Cass review calls for, without which there cannot be an evidence-based approach? Will she also set out that she will put in place the resources our young people need in terms of healthcare to ensure that they receive the healthcare appropriate to them?
Victoria Atkins
I thank the hon. Lady for giving me the opportunity to make it clear again that this report is about gathering the evidence to help support our children and young people to the best care they can have. For a very small number that may well be a medical pathway, but for the overwhelming majority we know from Dr Cass’s report that there may be other ways in which they can be best supported and looked after. I do not want anyone to walk away from this debate thinking that this is somehow a report about those adults who have made that decision of their own free will and are living their lives as freely as we all want them to—it is not. It is about the healthcare and emotional care and support that we give to young people and their families, and the professional confidence we give to clinicians to ensure that we get to the right place for each and every individual child.
Anna Firth (Southend West) (Con)
I welcome the Secretary of State’s powerful statement and the Cass report. However, we have to acknowledge that the report would not have been commissioned without this Government, with the support of some other parties. So many Opposition Members just stayed silent and thought the report was pretty much a waste of time, and to see the lack of any appreciation of that today is shocking and shameful.
On the timetable to enact the wider findings of the Cass report, I am grateful for what the Secretary of State said about meeting the GMC over the weekend, but there is work to be done. Secondly and really concerningly, what steps are—
Anna Firth
What are we going to do to provide emotional and psychological support for those who have already undergone this treatment with irrevocable consequences?
Victoria Atkins
My hon. Friend’s observations about Members from other parts of the Chamber and their response to this are well made, frankly. [Interruption.] Gosh, I am being told they are not true. Crikey, Opposition Members may have just opened up a Pandora’s box. On my hon. Friend’s point about supporting people who have gone through the process and are trying to detransition, she is absolutely right that they need particular care. I am actively looking into what NHS England needs to provide to look after the very complex needs that such people have.
Mr Ben Bradshaw (Exeter) (Lab)
Has the Secretary of State seen today’s very sad interview with Judge Victoria McCloud, Britain’s only senior transgender judge, who has been driven from her job because of anti-trans hate, particularly the trend among some politicians and opinion formers to describe being transgender as “an ideology”? The Secretary of State has used the term “ideology”, as have a number of her colleagues, during this statement. For the benefit of the House and trans people, will she clarify that she does not believe that being transgender is “an ideology”?
Victoria Atkins
I genuinely thank the right hon. Gentleman for giving me the chance to re-emphasise that. When I have talked about ideology, it is the ideology influencing or making assumptions about the provision of services for any child or young person who is questioning their place, sexuality, identity or future path in life. The ideology is the one that influenced the services that Dr Cass has set out so very well. Of course, if an adult chooses to live their life as a transgender adult then they must do so freely, and, I would hope, with compassion and understanding from all of us. By the way, I have been talking about this for many years; when I was Minister for Women, I talked about this subject. We must deal with this issue in a caring and careful way, and that is what Dr Cass emphasises in her report.
Robin Millar (Aberconwy) (Con)
I welcome this statement. The Cass report highlights the area of prescribing untested and irreversible drugs as puberty blockers to young people, but in Wales the pathway for young people diagnosed with gender dysphoria includes referral to gender services in England. The Cass report also warns against teachers being forced into making premature and effectively clinical decisions about affirmation, such as social transitioning, and yet that is implicit throughout the Welsh Government’s LGBTQ+ action plan and their compulsory relationships and sexuality education curriculum. Does the Secretary of State agree that these findings have relevance for the safeguarding of children in England and Wales? Does she agree that parents, teachers and health workers across England and Wales can expect politicians to take heed of these findings?
Victoria Atkins
I very much agree with my hon. Friend. He is always very good at exposing the differences in treatment that patients in Wales receive compared with those in England. Given that the leader of the Labour party has said that Wales is the “blueprint” for how it plans to run the NHS in England, I hope and expect that the Labour party will be true to its word and the Labour-run NHS in Wales will be announcing its immediate adoption of these recommendations, as well as the transformation to services that we in England are already undertaking.
Stella Creasy (Walthamstow) (Lab/Co-op)
Many of us recognise the value of the Cass report, as my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) set out, in its call for evidence and a thoughtful approach, and its recognition that the collapse of child and adolescent mental health services has contributed to the difficulties in children accessing services. However, I stand here today with terrified constituents who are part of the backlog. I dare say that thousands of those children have been watching this debate with their families and are frightened to hear the heat, not light. The Secretary of State has a brief in front of her, so can I ask her a practical question for my constituents who do not understand what this will mean for waiting times and delays? She said that she was not putting any new money into the service but funds were being reprioritised. In practical terms, what will that mean for those young people who are trying to navigate what is happening to them, who need our support and care, not the derision of any political movement?
Victoria Atkins
I refer the hon. Lady to the answer I gave earlier about funding. In relation to the waiting list, we have already removed the Tavistock as the single provider of these services. We have now set up two sets of services in highly respected—world-respected—children’s hospitals, and we will add more. Again, the issue goes back to giving GPs and other practitioners the confidence to look after these children as they would if they were presenting solely with, for example, ADHD symptoms or concerns about mental health. This is about saying that this issue is one part of the patient they must treat, not isolating and siloing it in the way that has happened historically.
Alexander Stafford (Rother Valley) (Con)
Providing hormone blockers to children is wrong; encouraging and giving cross-sex hormones to children is wrong; and encouraging breast binding for children is wrong. In the future, I believe we will look back on this scandal—and it is a scandal—with incredulity about how we did this to our children, especially our girls. We should all be embarrassed that this is the situation we are in. It is not just carrying on in our hospitals and the medical profession; this sort of ideology is going on in our schools. Does the Secretary of State share my concerns and those of my constituents, who have raised the issue with me in private because they cannot raise it publicly, that a school in Rother Valley is fundraising for Mermaids, a charity that is accused of encouraging young people to transition simply because they do not confirm to gender stereotypes, even though they are too young to understand the consequences? Does the Secretary of State share my belief that Mermaids and other such charities have no place in our schools, and no place to help to hinder our children?
Victoria Atkins
I thank my hon. Friend, and I will set out the practical and important steps NHS England has already taken, which I hope other parts of the United Kingdom will follow. NHS England has banned the prescription of puberty blockers for gender dysphoria to children under the age of 18. On the advice of Dr Cass, cross-sex hormones can be prescribed only with extreme caution for those aged 16 and older. No cross-sex hormones may be prescribed to those under 16 for gender dysphoria. There are medical caveats to that for other medical conditions, and we need to be very careful about unintended consequences, which is why this is such a complicated piece of work. We want to ensure that these drugs are prescribed to the right people, if they should be prescribed at all.
On my hon. Friend’s point about campaigning organisations, part of our collective frustration is that our public spaces have become politicised. I would say there is no space for that sort of campaign activity in any of our public institutions. I appreciate that a range of views must be represented. Young people must be helped to discover their path in life, their sexuality and all of the things that are such a wonderful part of growing up, but we have to do so in a way that is fair and rigorous, and does not give way against the evidence into the realms of ideology, which sadly we have seen in some instances.
Stephen Farry (North Down) (Alliance)
I welcome the Cass review. Its recommendations merit proper and full consideration. Dr Cass has called for young trans people, their families and clinicians to be treated with respect and compassion. Sadly, we have not seen that today in some of the comments and heckles that have been made during the statement. Will the Secretary of State commit to challenging the harmful culture of transphobia in the UK, which is growing, and that was challenged in 2022 when the Parliamentary Assembly of the Council of Europe placed the UK alongside Russia, Hungary and Turkey?
Victoria Atkins
If the hon. Gentleman wants to work constructively with me on ensuring that we deal with this report and the evidence in a caring and careful way, for the benefit not just of children and young people but of the wider trans community, I would welcome his support in so doing.
Zarah Sultana (Coventry South) (Lab)
Although I welcome the call from Dr Cass for all young people, including young trans people, to be
“treated with compassion and respect”,
I share concerns about important elements of the review, particularly given the context in which it was published. Last year, transphobic hate crimes hit a record high. A United Nations report noted deep concern about the increase in
“harassment, threats, and violence against LGBT people”
in the UK, and blamed the toxic debate about sexual orientation and gender identity. Will the Minister join me in condemning the rise in transphobia, in acknowledging that trans rights are human rights, and in recognising that we will only deliver high-quality healthcare that everyone deserves when we respect the rights and dignity of all?
Victoria Atkins
Not only have I tried to espouse those principles in every ministerial role that I have held, but it is the guiding light of this Government to try to ensure that we get the right healthcare and support to patients as quickly as possible. We also want to ensure that we are treating not just the condition, but the patient as a whole. As some of the complexity of the debates that we had this afternoon shows, young people are at the very heart of this. I think this is the final question, Madam Deputy Speaker, so I will end with the young people that we are concerned about. [Interruption.] I am so sorry; I have one more question from the hon. Member for Strangford (Jim Shannon). The children and young people who are the focus of this report have to be, and will be, the focus of our work going forward. We want to get the right services to the right children at the right time.
Madam Deputy Speaker (Dame Eleanor Laing)
I do not want to say that the Secretary of State could ever be wrong, but on her last judgment I have to say that the show is never over until the hon. Member for Strangford (Jim Shannon) has spoken.
Jim Shannon (Strangford) (DUP)
You are most kind, Madam Deputy Speaker. I know that I have now caught the Secretary of State’s eye.
May I thank the Secretary of State for her fortitude and determination, and Dr Cass for all her endeavours? Both ladies—honourable ladies, I believe—have been incredibly impressive and capable. We should be taking on board Dr Cass’s report in Northern Ireland. Indeed, I will make it my business to ensure that the Minister in Northern Ireland takes this in, so I shall be sending him a copy of the report. What help and support is available for all those patients who have been in the Tavistock since its inception? Importantly, what steps can be taken by the Government to stop this malpractice and to stop the movement of the vulnerable—some have called this tantamount to abuse—into privately funded abuse? How quickly can that protection be put in place?
Victoria Atkins
Let me offer the hon. Gentleman my sincere apologies; I am out of practice and should have known that his would be the last question.
I genuinely look forward to working with my Northern Irish counterparts on this, as we have already worked together on other matters. The hon. Gentleman makes a point about private practices. That is one area that I am working on at pace. What we do not want is to have any idea forming that somehow people can get round the strict rules that the NHS is setting the system to get these drugs to young people and children. I promise to come back and update the House when I have more news on that, but the hon. Gentleman is right to identify that issue. It shows the complexity of the matter and the real need for a very clear, detailed and principled approach to help reform our NHS so that we make it faster, simpler and fairer.
Cass Review
Victoria Atkins Excerpts(1 week, 5 days ago)
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The Secretary of State for Health and Social Care (Victoria Atkins)
Please refer to the oral statement I have made today on this subject.
[HCWS406]
Lampard Inquiry
Victoria Atkins Excerpts(1 week, 5 days ago)
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The Secretary of State for Health and Social Care (Victoria Atkins)
I am today updating Parliament that the terms of reference for the Lampard inquiry have been finalised and were published on 10 April on gov.uk under the heading “Lampard Inquiry: terms of reference”. A copy of a letter to the Chair of the Health and Social Care Select Committee and the terms of reference were also deposited in the Library of both Houses. Due to parliamentary recess, this statement is being made in Parliament today.
My deepest sympathies continue to go to all the families who have been affected by the tragic deaths of mental health patients across NHS trusts in Essex. Patients should feel confident, safe, and supported—especially when receiving help for their mental health, which can be a time of great vulnerability. This was not the case for many mental health inpatients in Essex between 2000 and 2023, where many patients ended up tragically and needlessly dying—leaving their bereaved families with questions that need answering. I wish to thank those families who met me while I considered the terms of reference.
The former non-statutory Essex mental health independent inquiry was converted to a statutory inquiry on 27 October 2023 and Baroness Kate Lampard was appointed as the chair of the inquiry.
The inquiry will examine:
Deaths of mental health inpatients within healthcare settings in Essex between 1 January 2000 and 31 December 2023;
Those who died as inpatients receiving NHS-funded care within the independent sector, as well as those in NHS units; and
Inpatient deaths, including those who died within three months of discharge from a mental health inpatient unit.
The inquiry will look at the delivery of treatment and care, the culture and governance of NHS providers, and their interaction with other public bodies, including commissioners, coroners, professional regulators and the Care Quality Commission. Other areas which will also be considered in relation to mental health inpatient deaths include the independent sector; serious harm short of death events; and neurodiversity and learning disabilities.
The inquiry’s work will now be a matter for the chair, Baroness Lampard. The Department will continue to support the inquiry with the resources it needs to undertake its investigations.
Baroness Lampard has indicated that she does not currently intend to appoint a panel to support her in this work and I concur with this view. If necessary, the chair may appoint any assessor(s) to assist her if she considers that person has relevant expertise that would assist the inquiry.
The terms of reference will enable the inquiry to start its work in earnest and provide the answers that affected families have been seeking for so long. I am pleased that the inquiry now has a firm basis on which to proceed, and we will ensure lessons are learned and patient safety is improved. Baroness Lampard and her team will undertake the inquiry thoroughly and as swiftly as possible.
[HCWS403]
Nottinghamshire Healthcare NHS Foundation Trust: CQC Review
Victoria Atkins Excerpts(1 month ago)
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The Secretary of State for Health and Social Care (Victoria Atkins)
On 30 January 2024, I requested that the Care Quality Commission conduct a special review of mental health services in Nottinghamshire under section 48 of the Health and Social Care Act 2008. The review includes three strands of activity.
Part 1 is a rapid review of the evidence related to the care of Valdo Calocane. I have asked the CQC to report on part 1 by June, with the aim of providing much needed answers to the families of Barnaby Webber, Grace O’Malley-Kumar and Ian Coates whose lives were taken so brutally in the horrific events in June 2023.
Part 2 is an assessment of patient safety and the quality of care provided by Nottinghamshire Healthcare NHS Foundation Trust to improve the standard of mental health care at the trust.
Part 3 is an assessment of progress made at Rampton Hospital since the most recent CQC inspection activity to offer an up-to-date assessment of the service provided at the hospital.
Today the CQC have reported on part 2 and 3 of this review.
I am grateful to the CQC for the rapid and extensive work that has been undertaken as part of this review. As set out in its report, the CQC has found highly concerning failings in the trust’s ability to manage demand for services and access to care, staffing, and issues of leadership at the trust. This is not acceptable and must be improved. The trust has already begun work to address areas of risk such as patients who are waiting to access care. The trust board have accepted the recommendations made by the CQC and will address each recommendation through an improvement plan.
Since I asked for the review, the trust has been evaluated by NHS England and given a rating within their national oversight framework of 4, which means it now subject to regulatory action and the highest degree of national oversight. This includes being entered into the national recovery support programme. An improvement director has been appointed to manage the trust’s progress through the recovery programme, and delivery of its improvement plan, which is being supported by system partners and NHS England.
I expect to see significant action and improvements. I have asked NHS England to work with my officials to provide assurance that their programme will provide targeted support for the issues identified, and to be updated on improvements at the trust.
I also asked that the CQC, as part of its review, assess the services at Rampton Hospital to inform my decision about the reauthorisation of Nottinghamshire Healthcare NHS Foundation Trust as a provider of high-security psychiatric services. The CQC has found that, while some progress has been made at Rampton since its last inspection, there are still significant improvements to be made. Following this assessment and the recommendations from NHS England’s assessment across all three high-security hospitals, I have decided to reauthorise Rampton for a period of 12 months only, with conditions attached to address the concerns raised by the CQC and to continue to sustain the improvements it found at the hospital. I will review the progress made against these conditions before the end of the 12-month period and make a further decision about whether to renew the authorisation and what further steps are necessary, if any.
The Government remain committed to expanding and improving mental health services. This is reflected in the investment that has gone into services, with NHS spending on mental health increasing by £4.7 billion in cash terms between 2018-19 and 2023-24.
I will update the House again when the CQC provides its report on part 1 of the review in June.
[HCWS391]
Mental Health: Expected Spend
Victoria Atkins Excerpts(1 month, 1 week ago)
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The Secretary of State for Health and Social Care (Victoria Atkins)
The Health and Care Act 2022 introduced a statutory requirement for the Government to publish an annual statement setting out expectations for NHS mental health services spending. This is to ensure better transparency as part of the Government’s commitment to parity of esteem, ensuring that patients can access services that treat both mental and physical health conditions equally and to the same standard. It also supports the Government’s commitment to uphold the mental health investment standard, which requires that integrated care boards’ spending on mental health grows at least in line with growth in overall recurrent funding allocations. 2022-23 2023-24 2024-25 Recurrent NHS baseline (£billion) 142.4 154.7 164.0 Total forecast mental health spend (£billion) 12.6 13.9 14.8 Mental health share of recurrent baseline (%) 8.87 9.00 9.01
In January 2023, my predecessor made the first annual statement. Today I am publishing this second annual statement. It should be noted that, owing to the statutory requirement to make this statement before Parliament ahead of the new financial year, the figures for 2024-25 are the best current estimate based on projections that take account of draft planning guidance allocations, which will be published shortly. Figures for 2023-24 are based on month 11 forecast, as full-year spend is not yet available. There are also revised figures for 2022-23 and 2023-24 compared with the first annual statement made in January 2023.
In financial year 2022-23, mental health spending made up 8.87% of all recurrent NHS spending and 41 of 42 integrated care boards met the mental health investment standard. This is compared with our original forecast of 8.90% in January 2023.
In financial year 2023-24, mental health spending is forecast to make up 9.00% of all recurrent NHS spending, and all integrated care boards are expected to meet the mental health investment standard. This is compared with our original forecast of 8.92% in January 2023.
For 2024-25, mental health spending is forecast to make up 9.01% of all recurrent NHS spending, ensuring spending on mental health continues to grow in line with growth in overall recurrent funding allocations.
These encouraging projections, shown below, demonstrate the Government’s continuing commitment to expanding and transforming mental health services across England and to delivering sustained investment in this area across the country, and our ongoing commitment to parity of esteem for mental health.
This includes the total of all integrated care board baseline spend within scope of the mental health investment standard, which covers all spending on mental health from an integrated care board’s core allocation. It also includes, at NHS England level, service development fund spending and specialised commissioning spending on mental health.
These figures are different to those on the mental health dashboard, which includes learning disabilities and dementia spend in addition to mental health spend. It also compares integrated care board mental health spend to integrated care board allocations.
The autumn statement 2023 funding for NHS talking therapies, which totals to £21 million, is included in the total mental health spend in 2024-25. Additional spring Budget 2023 and autumn Budget 2023 funding for individual placement support, which totals £20 million, is also included.
Although capital spend is not included in the mental health investment standard or in the figures for total mental health spend, the Government are spending over £400 million during a four-year period, which started in 2020-21, to replace 1,370 dormitory beds in the mental health estate across England.
We remain committed to expanding and transforming mental health services across England.
[HCWS367]
Health and Social Care
Victoria Atkins Excerpts(1 month, 1 week ago)
Ministerial CorrectionsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Victoria Atkins
The hon. Gentleman articulates the case against Labour-run Wales with great power. There is £200 million on top of the £3 billion that we already spend on NHS dentistry in England.
[Official Report, 7 February 2024, Vol. 745, c. 264.]
Victoria Atkins
We have finite resources. As I have said, this is additional money. I have prioritised dentistry across the board, but this is £200 million of additional money—in addition to the £3 billion that we spend in England.
[Official Report, 7 February 2024, Vol. 745, c. 266.]
Letter of correction from the Secretary of State for Health and Social Care:
Errors have been identified in the responses I gave to the hon. Members for Carmarthen East and Dinefwr (Jonathan Edwards) and for Arfon (Hywel Williams). The correct responses should have been:
Victoria Atkins
The hon. Gentleman articulates the case against Labour-run Wales with great power. There is £200 million as part of the £3 billion that we will spend on NHS dentistry in England.
Victoria Atkins
We have finite resources. I have prioritised dentistry across the board. This is £200 million as part of the £3 billion, that we will spend in England.
Oral Answers to Questions
Victoria Atkins Excerpts(1 month, 3 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Dr Alan Whitehead (Southampton, Test) (Lab)
The Secretary of State for Health and Social Care (Victoria Atkins)
The Government’s 2021 fuel poverty strategy recognised that warm homes can help to reduce health inequalities and pressure on the NHS. That is a key reason why we are delivering a package of cost support worth £3,700 per household on average from 2022 to 2025 and investing heavily in fuel efficiency.
Dr Whitehead
The recent Institute of Health Equity Marmot report highlighted the negative effects of living in cold and uninsulated homes, including respiratory and circulatory diseases and hampered lung and brain development in children. Last year, the Energy Systems Catapult and a number of NHS providers ran a trial of warm homes prescriptions, with NHS practitioners identifying vulnerable patients and supporting them with their energy needs. I think that the Secretary of State has accepted the link between cold homes and health outcomes. If that is the case, are the Government considering expanding this approach, or looking for alternative ways in which the health system and fuel poverty prevention can go hand in hand?
Victoria Atkins
The hon. Gentleman is right to say that a number of local warm homes prescription schemes have offered additional support to help people with health vulnerabilities to stay warm and well. Such schemes are excellent examples of local collaboration between the NHS, local government and other partners—tailored, of course, to the local needs of their areas—and I would be interested to see whether other parts of the NHS choose to take up these sorts of ideas in the future.
Mary Robinson (Cheadle) (Con)
Greg Smith (Buckingham) (Con)
The Secretary of State for Health and Social Care (Victoria Atkins)
We have met our manifesto commitment to deliver a record extra 50 million GP appointments annually. Our primary care recovery plan addresses increased GP access and expands community pharmacy services nationwide with Pharmacy First. Our NHS dentist reform plan also allocates resources for 2.5 million appointments, targeting rural and coastal communities.
Julie Marson
I thank the Secretary of State for her response, and I thank the Minister for Health and Secondary Care, my right hon. Friend the Member for Pendle (Andrew Stephenson), for visiting the community diagnostic centre and minor injuries unit at the Herts and Essex Hospital yesterday and all the fantastic staff there.
Frontier Estates committed to building a GP surgery as part of the wider Stortford Fields development. However, citing inflated build costs, it now questions the viability of the plans despite months of negotiations and efforts by the local NHS to find a solution. Will my right hon. Friend work with colleagues in the Department for Levelling Up, Housing and Communities, with whom I have already met on this issue, to ensure that Frontier really engages with the process and builds the surgery it promised my constituents?
Victoria Atkins
I congratulate my hon. Friend on the enormous amount of work she has done in her constituency to secure that community diagnostic centre. We have rolled out some 160 or so of those centres across England —we want to do more—and they are supplying some 6 million tests and scans for patients across England.
On the important issue that my hon. Friend raised, my officials and Levelling Up officials are already considering how primary care infrastructure can be better supported in the planning process to ease the pressure on primary care estates, particularly in areas of housing growth. I know that she will continue to be as conscientious in her campaigning on that as she is on other matters.
Greg Smith
Rural communities need local, easily accessible primary care. Since Long Crendon surgery closed during the pandemic, patients in that village and surrounding villages have been displaced, mainly to Brill and Thame, for GP appointments. For the vulnerable and those without private cars, the absence of regular bus services can mean an unaffordable £25 at least in taxis to see a GP. I have raised many times an innovative approach to building a new health centre in Long Crendon by the parish council, which has the land and the agreement by the ICB for the rent to put Unity Health in there—we just need the money to build it. Will my right hon. Friend break down every barrier to help us get that health centre built in Long Crendon?
Victoria Atkins
Again, I very much admire the effort and determination that my hon. Friend is showing to stand up for his constituents. He will know that sadly I am constrained from commenting on individual cases, but what I do know is that the innovation he is showing alongside his parish council—and, indeed, I would hope, his local integrated care board—is the approach we want to adopt across our rural and coastal communities to ensure that they, too, have the access to primary care that we all expect.
Valerie Vaz (Walsall South) (Lab)
Equal access to primary care is so important, but the use of physician associates is downright dangerous. Does the Secretary of State agree that patients have the right to see a qualified GP and not be fobbed off with a two-tier primary care system?
Victoria Atkins
I understand the concerns—we have seen them in the media—but, please, we in this House have a responsibility to our constituents and to professionals working in healthcare, including our clinicians and physician associates. In fact, physician associates have been working in the NHS for some two decades. They are there to work with doctors to assist them, freeing up doctors’ time to focus on the tasks that only they are qualified to do. We have been very careful to listen to the concerns raised, which is why we recently announced intentions to regulate them. But, please, we must all take that responsibility for ensuring that we are not spreading concern. Actually, these roles can have a very positive effect on healthcare system.
Alistair Strathern (Mid Bedfordshire) (Lab)
My constituents are fed up with battling to see a GP. I have been working hard across party lines with local councillors and the ICB, but I was surprised to hear from the Prime Minister in response to a question last week that only £2 million was allocated to my ICB for primary care, and that it should raid its hospital refurbishment budget instead. Could the Secretary of State advise me which part of the much needed hospital investment should be overlooked to compensate for the failure to invest in primary care locally?
Victoria Atkins
Again, it is for integrated care boards to assess the needs of their area. If there are concerns about access to primary care, we are keen to give them the autonomy to make decisions about how they spend their budget. We have set expectations of integrated care boards in a couple of respects—in particular, we expect them to use the money that we have provided for dental care and we have set clear expectations that integrated care boards will introduce at least one women’s health hub in their area this year.
Steve Brine (Winchester) (Con)
While we are talking about the recovery of primary care and the Secretary of State is at the Dispatch Box, the recovering access plan released last May talked about high-quality online consultation, text messaging services and online booking tools. They were due in July, but that became August and then December, and I understand that it has now been delayed indefinitely due to a claim made against NHS England in what is a £300 million project. That delay is hitting access to primary care. Will the Secretary of State update the House?
Victoria Atkins
We are determined to bring not just primary care but the whole NHS up to speed with technology. We are firm advocates of the idea that technology can help free clinicians’ time and ensure that they are spending time looking at their patients rather than at computer screens. In primary care, we are working to ensure the digital telephony services that have played such a critical role in providing those 50 million additional appointments, as I described. I will take away my hon. Friend’s points, and look into them carefully.
Daisy Cooper (St Albans) (LD)
I have been corresponding with the Primary Care Minister, the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), and her predecessors about urgently needing to protect general practice locations in city centres from outdated Treasury rules that potentially force them to move to ring-road locations. The Minister’s latest reply suggested that the ICB could use capital funding to pay for new premises, but my ICB claims that that is against the rules. Would she and her officials please urgently meet me and my local ICB to bottom out what the rules are and urgently protect our city centre GP locations?
Victoria Atkins
I will ask the relevant Minister to write to the hon. Lady.
Wes Streeting (Ilford North) (Lab)
The simple fact is that the Conservatives have been in power for 14 years, and general practice has never been in a worse state. Despite slogging their guts out, GPs are struggling because this Government have cut 2,000 GPs since 2015, making it even harder for patients to get an appointment. Given that, why has the Government decided that the NHS needs what the Institute for Fiscal Studies has described as the biggest funding cut since the 1970s?
Victoria Atkins
It has been a very long time since Labour were in government, but even the hon. Gentleman knows that Ministers will never comment on fiscal events the day before they occur. Let me introduce some facts into his analysis. We have now delivered on our manifesto commitment for 50 million more general practice appointments per year, with 363.8 million booked in the last 12 months. That compares with 312 million deliveredin the 12 months to December 2019. [Interruption.] If the hon. Gentleman stopped shouting, perhaps he would be able to hear me. About 62,000 more appointments were delivered per working day last December, excluding covid vaccinations. We have our primary care recovery plan, and it is working. Of course there is more to do, but even the hon. Gentleman would not be so churlish as to deny those extra 50 million appointments.
Paul Girvan (South Antrim) (DUP)
Ms Lyn Brown (West Ham) (Lab)
The Secretary of State for Health and Social Care (Victoria Atkins)
Women’s health is one of my top priorities. As we approach International Women’s Day, we have already improved access to contraception and the treatment of urinary tract infections through Pharmacy First, announced £50 million of funding for research on maternity disparities and other health conditions affecting women, and set the expectation that each integrated care board area will have at least one women’s health hub operating this year.
Ms Brown
For more than a decade I have been raising the appalling, often agonising treatment of many women who need hysteroscopies in the NHS. They are being left with unnecessary trauma and are reluctant to engage further with doctors, which is quite simply life-threatening. However, the medical establishment continues to resist change and the Government shirk their leadership role. Earlier this year the Secretary of State set out her priorities for the women’s health strategy, and access to pain-free hysteroscopy was not included. Why?
Victoria Atkins
I thank the hon. Lady for her work in this regard, and I absolutely acknowledge the issues that women are experiencing with this highly invasive procedure at what is often an extremely distressing time in their lives. We are waiting for the Royal College of Obstetricians and Gynaecologists to update its guidelines on best practice in hysteroscopies. Following consultation last year that is under peer review, and is due to published soon. However, as the hon. Lady knows, I am clear that it should not be the responsibility of women in those very distressing circumstances to ask for pain relief. Clinicians must assume that a woman wants it, and discuss that with her before the procedure.
Theo Clarke (Stafford) (Con)
I welcome the Government’s recent refresh of the women’s health strategy and the addition to it of birth trauma. However, I am currently chairing a national inquiry into birth trauma, and we are hearing from mothers throughout the United Kingdom about some of the severe mental health conditions that they are facing, including postpartum psychosis. I have been particularly concerned to hear about the risk of suicide among new mothers. What action are the Government taking to address this?
Victoria Atkins
Let me put on record my admiration for my hon. Friend’s action in sharing her own experiences in order to improve healthcare for women across the country. She will know of yesterday’s important announcement about suicide prevention, elements of which addressed exactly the concerns that she has rightly raised. Thanks to her hard work, we have also announced that within eight weeks or so of giving birth mums will be asked by GPs whether they are okay, and we hope very much that that will open up the conversation with women who may be struggling.
Alison Thewliss (Glasgow Central) (SNP)
Amma Birth Companions has just been recognised in the 2024 GSK IMPACT awards. The charity is doing really important work to support vulnerable asylum seekers and refugees who would otherwise face giving birth alone. Will the Secretary of State meet the charity to discuss its work and research, given the disparities that continue for this group of women?
Victoria Atkins
The hon. Lady describes a very interesting piece of work. I will ask my ministerial colleague to meet the charity, as we want to support women. Indeed, part of our work across the women’s health strategy is ensuring that maternity services are not just safe, but trusted by mums-to-be.
Sir Michael Ellis (Northampton North) (Con)
With regard to healthcare for women, a gynaecologist who claimed that Hammersmith would be better if it were “Jew free” has been ruled as not racist, but merely
“comfortable with using discriminatory language”,
according to the Medical Practitioners Tribunal Service. He was merely suspended for three months and is due to start seeing patients again in a few weeks. I am concerned that this doctor may be a danger to Jewish patients. I am also concerned that the tribunal is defective and its decision is grossly unreasonable. Will the Secretary of State instruct Government lawyers to begin judicial review proceedings against the tribunal?
Victoria Atkins
I sincerely thank my right hon. and learned Friend for raising this issue. As the Prime Minister set out on the steps of Downing Street last week, there are people whose ideology and dogma are in direct conflict with our country’s shared values. Just as we will not stand for that across the country, nor will I stand for it in our NHS. I have already written to NHS England and regulators, setting out their responsibilities and our expectations of them, and I can assure my right hon. and learned Friend that I will be looking into this issue with great urgency and great care.
John Penrose (Weston-super-Mare) (Con)
The Secretary of State for Health and Social Care (Victoria Atkins)
I am committed to making our NHS faster, simpler and fairer for all, including families, which is why the Government have recently introduced baby loss certificates. Nothing can diminish the pain of losing a baby, but we hope that this formal recognition of a life lost can help families to live alongside their grief. Indeed, since we announced the launch some two weeks ago, more than 37,000 certificates have been requested by parents.
That same commitment to families is why we are rolling out Martha’s rule across England, giving patients and their families the automatic right to a rapid review of their case—24 hours a day, seven days a week. Families and carers know when something is not right or their loved one’s condition is deteriorating. Martha’s rule not only recognises this powerful instinct, but allows anyone concerned to act on it and to make sure that the NHS listens.
With your permission, Mr Speaker, for which I am very grateful, I would like to alert the House to a written ministerial statement and a detailed letter from NHS England that has been laid this morning. It addresses a historical issue whereby women who received radiotherapy above the waist to treat Hodgkin lymphoma, and who were therefore at a higher risk of breast cancer, were not given annual checks. Yesterday, the NHS wrote to the 1,487 women affected in order to inform them. We expect all women to be offered a scan within the next three months, and NHS England has established a helpline and briefed GPs and relevant charities. The vast majority of this group of women will already have been receiving screening on a three-yearly basis, but NHS England wants to ensure that they receive annual tests, in line with the clinical guidance.
I wanted to alert hon. Members to that because, with the letters having been sent out yesterday, it is perfectly possible—indeed, probable—that they will start to receive queries from their constituents. I will of course keep the House updated. I emphasise, however, that what I have given is a summary, and I would encourage hon. Members to look at the very detailed letter from NHS England in order to reassure their constituents that we are scooping up everybody we can to look after them at this very troubling time.
John Penrose
Like many people here, I was delighted by last month’s NHS dentistry recovery plan. How many new NHS dental appointments does the Secretary of State expect to be available in my constituency of Weston-super-Mare, and by when?
Victoria Atkins
I thank my hon. Friend for supporting our dental recovery plan. Indeed, he is one of many colleagues who campaigned hard for it. I am pleased to inform him that dental activity, as measured by courses of treatment, has increased by 15% on the previous year in his local integrated care board area, and our plan will support further increases to dental access through some 2.5 million additional appointments across the country, including in his constituency. The first measure, namely new patient premiums, went live on Friday, and we hope to have the results very soon.
Wes Streeting (Ilford North) (Lab)
With a general election in the air, I welcome what the Secretary of State has said about baby loss certificates and Martha’s rule—there is genuine cross-party agreement on this. I also thank her for advance notice of today’s important written ministerial statement.
However, with a general election in the air and given the Secretary of State’s principled, vocal and consistent opposition to funding the NHS by abolishing the non-dom tax status, on a scale of one to 10—one being utterly shameless and 10 being highly embarrassed—how red-faced will she be when the Chancellor adopts Labour’s policy tomorrow?
Victoria Atkins
One of the joys of being at the Government Dispatch Box is that not only do we have to deal with very serious matters, such as I have just set out, but we get to have a knockabout on the Labour party’s electioneering. The hon. Gentleman will know the Conservatives’ proud record on funding our NHS since 2010. I invite him to wait for tomorrow’s Budget to see what more this Conservative Government are doing to support our constituents, and to help our economy grow for a bright future.
Wes Streeting
The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), has said that the policy will be
“as much use as an ashtray on a motorbike.”—[Official Report, 28 February 2023; Vol. 728, c. 710.]
As she speeds down the A23 back to Lewes, to defend her constituency against the Liberal Democrats, how on earth will she feel with all those embers of the Conservatives’ 14-year record blowing in her face?
Is it not now clear that, with the Government having adopted Labour’s workforce plan, Labour’s dentistry recruitment plan and now Labour’s NHS funding plan, when it comes to a record to be proud of, and when it comes to finding the answers, only Labour can deliver an NHS that is fit for the future?
Victoria Atkins
The Leader of the Opposition is a former barrister, and barristers like to rely on evidence, so let me give some evidence on what the Labour-run NHS in Wales looks like. People are almost twice as likely to be waiting for treatment under the Labour-run Welsh NHS—21.3% of people in Wales are waiting for hospital treatment after a consultant referral, compared with 12.8% in England. Patients in Labour-run Wales are, on average, waiting five weeks longer for NHS treatment than patients in England, and the number of patients in Wales who are escaping to seek treatment in England has increased by 40% in two years. But don’t worry, folks, according to the Leader of the Opposition this is the blueprint—
Mr Speaker
Order. I remind everyone that these are topical questions. It is about the many Members I need to get in, rather than the ping-pong over the Dispatch Box. Let us move on to Andrew Jones as a good example.
Victoria Atkins
Again, I thank the hon. Lady for sharing her experience, and of course we are doing all we can. I know that the SNP Scottish Government share our determination to ensure that cancer treatment continues to improve. England is diagnosing earlier and treating more. We have seen cancer survival rates improve by almost 10 percentage points since 2005, but we also know that four in 10 cancers could be prevented, which is exactly why we are bringing forward the smoke-free generation work. Of course, if the Scottish Government would like us to help with some of their waiting lists, we genuinely stand ready to do so.
Andrew Selous (South West Bedfordshire) (Con)
George Freeman (Mid Norfolk) (Con)
Rural Norfolk is experiencing a dental crisis and a generation of children are in danger of going without dental care. I welcome the dental recovery plan, but I notice that it will be four or five years before we get more dentists. Last week, NHS Norfolk and Waveney integrated care board announced a £17 million underspend on dentistry. Will the Minister agree to meet with me and the ICB to work out how we get more money out now to help dentistry in Norfolk today?
Victoria Atkins
One of the many ways we have tackled access to dental care is to ensure that those dentists who have a contract to conduct NHS work are using them to the top of their licence. We are encouraging dentists to do that through the new patient premium and a higher rate paid for units of dental activity. There is so much more to the plan. Labour keeps trying to claim credit for our plan, but the truth is that our plan promises 2.5 million appointments while its plan promises a miserly 700,000.
Rachel Hopkins (Luton South) (Lab)
It is imperative that we tackle the scourge of mental ill health in children and young people. Labour will ensure access to mental health support in every school and establish an open-access mental health hub in every community, paid for by charging VAT on private school fees. Why will the Government not adopt that plan?
Florence Eshalomi (Vauxhall) (Lab/Co-op)
The Secretary of State will know that NHS England is expected to announce the decision about the primary children’s centre for cancer treatment in south London and south-east London. Evelina London Children’s Hospital in my constituency is one of the only specialist centres in south London. Does she agree that the final decision should be made as soon as possible in order to benefit staff, patients and families? Will she join me in visiting Evelina London?
Victoria Atkins
I thank the hon. Lady for her question. In fairness, colleagues from across the House have been raising this issue with me because it affects a large population of London and the surrounding areas. I must leave it to NHS England to finish its consultation process, but I would be very happy to visit not just the Evelina but our other wonderful hospitals that look after children.
Maggie Throup (Erewash) (Con)
Given the expansion of health services through Pharmacy First, what action is my right hon. Friend the Minister taking to ensure that communities such as Sandiacre in my constituency, whose branch of Boots is due to close at the end of the month, are not left without access to such vital services?
Mr Gregory Campbell (East Londonderry) (DUP)
On access to primary care provision, will the Secretary of State assure the House that she will liaise with Health Ministers in the devolved Departments to ensure that rural communities do not lose out because of their isolated locations?
Victoria Atkins
I am very happy to give that assurance. I was delighted to meet Minister Swann yesterday to discuss his plans for Northern Ireland healthcare, including access to primary care.
Will Quince (Colchester) (Con)
No doctor wants to be on strike, so I welcome the new deal with the consultant unions. It shows that by being reasonable, pragmatic and acting in good faith, unions can deliver for their members. Does my right hon. Friend agree?
Victoria Atkins
My hon. Friend knows only too well the importance of industrial action and the impact it can have on patients and on the NHS as a whole. I am pleased that the BMA has announced today, following the previous settlement that was narrowly rejected in its ballot, that it has been able to get back around the table with my officials and me. We have been able to find a fair and reasonable settlement that the BMA will advocate for and recommend to its members. We hope that that shows those who are choosing to strike that constructive negotiations, and trying to sort out some of the concerns that we know clinicians have, can be dealt with in a reasonable manner, which is of benefit not just to staff, but to patients.
Sir Chris Bryant (Rhondda) (Lab)
How many people were treated for acquired brain injury last year?