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

Debate between Will Quince and John Hayes

Monday 20th March 2023 General Committees

[Will Quince]

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

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

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

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

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

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

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

[Sir John Hayes (South Holland and The Deepings) (Con)]

I am sorry to have missed the beginning of the Minister’s remarks, but I want to make a case for dentistry in all this. Given that the aim of the draft regulations is to align the workforce more with local need, and that they are designed to improve care standards and workforce availability, will he look at the dental deserts such as Lincolnshire, where we cannot straight-forwardly access NHS dental care? There are more dentists in London than one could shake a stick at—there are even more than there are barbers—yet in Lincolnshire it is very hard to obtain a dentist. Would he look at that in terms of the strategic change that he has described?

[Will Quince]

I thank my right hon. Friend for his question. He is right to raise dentistry, because, as he rightly points out, there are dental deserts across the country. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), is looking closely at dentistry, including workforce and supply and the use of a skill mix. Of course, it does not have to be a dentist, as others who have similar qualifications can do a lot of work that a dentist does, including on children. My hon. Friend will publish a dental plan in the coming months, and I hope that addresses my right hon. Friend’s point.

In conclusion, the merger will continue to build on Health Education England’s great work, putting education and training at the heart of service planning for the long term. The draft regulations will simplify the architecture of our NHS at national and regional level and ensure it has the workforce that it needs now and in the future. I commend the regulations to the Committee.

Offensive Weapons Bill

Debate between Will Quince and John Hayes

2nd reading: House of Commons & Money resolution: House of Commons
Wednesday 27th June 2018 Commons Chamber

[Will Quince]

I broadly agree with my right hon. Friend. When we criminalise a child at a young age, the problem is that their life chances are impaired to such an extent that a life continuing along the route of criminality is sadly almost inevitable. We should break that cycle when we have the opportunity to intervene—such opportunities are often rare—and ensure that we put them back on the right path. One way to do that is to ensure that a criminal record does not stay with a child forever. For example, someone might commit an offence at a young age after they have been groomed or forced into that action due to violence and intimidation. They could then completely turn their lives around and think, 10 years later, “I want to contribute by becoming a police officer and serving my community.” Currently—I stand to be corrected by the Minister—that would not be possible, because their criminal record continues. I wholeheartedly agree with my right hon. Friend.

I welcome the Bill and will support its Second Reading. It has huge merits but, as a number of right hon. and hon. Members have said, it is not without issue. By its nature, it is reactive legislation that deals with weapons that gangs and criminals have moved on to. Some of those weapons—knives and corrosives—can probably never truly be banned, as we all know that they are available in households across the country. I could probably find several in my kitchen. We need to ensure that we have a multifaceted approach to tackling this issue, and the serious violence strategy has a significant role to play.

First, we need to make sure that our legislation gives the police the powers they need to deal with offenders, which is one thing that the Bill does. Secondly, we need to make sure that, when we intervene, we do so as early as possible. We need to turn children away from gangs and, indeed, when they are the victims of gangs or grooming, we need to give them the protection and support they need.

As I have said previously in the Chamber, we need education in schools to ensure that children know the dangers of carrying a weapon. There are some fantastic charities across the country—many have been set up by parents who have lost a child to knife crime—that go into schools to educate children about the danger of carrying knives. The charities teach children that they are far more likely to be the victim of a knife attack if they carry a knife themselves, and they show them in a graphic way the devastation caused by a knife attack. They show the awful wounds, and they also show what it feels like to be a family member whose child is in hospital or, even worse, has been fatally wounded or murdered.

Thirdly, judges need a full range of sentencing powers so that a person who is repeatedly caught carrying a knife, or who is caught harming an individual, can be given a custodial sentence. I agree with Members who have said that we need to come down very hard on those who are repeatedly caught carrying a knife or weapon, and on those who harm another individual, but there need to be other solutions, such as educational and non-custodial approaches, so that we do not fill our prisons with young people who have lost their future.

At the moment, an individual who is caught carrying a knife may get just a caution. In my view, they should also be sent on a weapons awareness course. A person who is caught speeding, for example—I am not conflating carrying a knife and speeding but, to some extent, it is a useful comparison—has the option of paying a fine or going on a course. It should be mandatory that a person who is given a caution for any kind of weapon-related offence is sent on a course. They should have to see the devastation caused by such weapons, which hopefully would go some way towards breaking their attitude towards carrying a weapon and knife crime. That would not work for everyone, but for some individuals, especially those who are particularly young and have made a mistake—for many first-time offenders it will be just a mistake—it might just break the cycle, and at very small cost. Such courses are, in many cases, run by charities across the country.

Fourthly, we need to identify and address the root causes of this criminality. Why do people carry weapons? How has our society got to this position? It could be social breakdown, regional inequality, family breakdown, absent father figures or a lack of male role models. It could be school exclusion, which has been mentioned, or social isolation—gang culture can provide a sense of belonging. It could be county line activity or prostitution. It could actually be education and the messaging we send out about drugs and drug use.

I find it bizarre that we have middle-class people in this country who drive around in their electric vehicles, drinking their Rainforest Alliance coffee and eating their Fairtrade chocolate, but who have no qualms whatsoever about going out at the weekend and having a few lines of coke, because that does not harm anyone, does it? If only those people saw the devastation that that causes both in the country where the cocaine is sourced from and through the county line activity in this country that takes the drugs from the point of entry to the point at which they are sold. If only they saw, in so many cases, the children whose lives have been devastated as a result. We need to send a clear message that drug taking is not acceptable and that, through the damage it does, it is not a victimless crime.

[Mr John Hayes]

My hon. Friend is making an excellent point that deserves amplification. The gated-lived, middle-class liberals who take drugs have little or no care because they have little or no contact with the kind of people he describes. It is the people on the frontline who suffer, and they deserve to be treated as a priority.

[Will Quince]

I thank my right hon. Friend for that intervention. It is important to note, though, that although in the past people have thought, “This isn’t a problem for us—this isn’t something that our children would be involved in,” the reality is that it is now quite the opposite. These grooming gangs are looking for people who are not stereotypical. They are looking for children who are particularly vulnerable, and that is not just children from socially deprived backgrounds or from council housing estates—the people one would perhaps automatically associate with being easy prey for some of these grooming gangs—but the young people who are easiest to groom and are less likely to be stopped and searched by a police officer. The enemy is at the gate, and to think that our own children and the children of middle-class families are not as affected as anybody else is a myth. It is a dangerous assumption not to think that every single part of our society and every town in our country is affected, and even rural areas. We should absolutely send out the message loud and clear that this affects everybody’s children, not just somebody else’s.

On root causes, we need to take a much tougher stance on antisocial behaviour. If we do not take a tougher stance on very low-level crime, it will be easier for people to think that other crimes are acceptable. A policing focus on drugs would be particularly helpful. To tackle the issues, we really need to understand the root causes. The strategy goes some way towards achieving that, but there is more work to do.

Let me turn to the specifics of the Bill. There is no reason whatsoever for under-18s to be able to buy these weapons, nor for them to carry them in public, so I very much welcome the Government’s position. There is also no reason to possess certain weapons in private properties. There is no justification for having zombie knives, knuckle dusters and death stars, even in private possession.

--- Later in debate ---

[Mr John Hayes (South Holland and The Deepings) (Con)]

It is a prevalent liberal misassumption that things can only get better. Their mindset is that progress is inevitable and that whatever we do, society will advance. It is true that, as Disraeli said:

“Change is inevitable…change is constant”,

but things can simultaneously deteriorate as well as improve. In my lifetime, there is no question but that that is exactly what has happened.

In the 60 years of my life—I know you are thinking, Mr Deputy Speaker, “How can that possibly be true? How can that callow youth standing before me possibly have been born in 1958?”, but it is true—civil society has been weakened, respect for authority has dwindled and many of the once routine civilities and courtesies that mitigate the inevitable pitfalls of human existence have been derided, eroded or abandoned. Consequently, life is less gentle than it was when I was a boy. Many have been brutalised and some are brutal. It is very difficult for the liberal establishment to come to terms with that, because the unhappy reality of increasing disorder and criminality contrasts with the myth of progress. It is therefore either disguised or ignored by those who cannot bear to face the facts.

I thought I would offer the Chamber some of those facts this afternoon. They are so extraordinary that when I researched them, I could barely believe them, but they are based on information available from the Library. In the year of my birth, 1958, the total number of violent criminal incidents was 31,522. At the end of 2014—a year for which the figures are available—the total number of violent incidents was 1,245,000. This is an extraordinary change. Even allowing for the change in population, which is significant, and for the changes in the definition of crime, which are not irrelevant, the truth is that there has been an explosion in the amount of serious and violent crime in our country. Most Members in this Chamber will know someone in their circle, family or beyond who has been a victim of some kind of serious or violent crime. Of course, we know that our constituents have been, but many of us will have encountered it in a much more familiar way than that.

[Will Quince]

Notwithstanding my right hon. Friend’s point, does he accept that it has become a lot easier—in fact, has never been easier—to report a crime?

[Mr Hayes]

It is true that in criminal statistics there is the well-established principle of the dark figure—the number of crimes never discovered because they are never reported—and that this also needs to be taken into account in any comparative analysis, which is why I qualified mine heavily before I offered it.

None the less, in the year of my birth there were 1,194 recorded robberies; the number now, extraordinarily enough, is 74,130. We have had roughly a seventyfold increase in the number of robberies during the 60 years of my life. This is indeed an extraordinary change. As parliamentarians, our recognition and acceptance of this is an important part of reconnecting ourselves with the lives and assumptions of the people who suffer these kinds of crimes. The more we detach ourselves from this reality and bury our heads in the sand, the more people believe we either do not know or, worse, do not care. I know that people across the Chamber do care, but denial is not good enough.

That is why I welcome the Bill. It is an important acceptance that action is needed, that further measures are required. It is not, of course, the whole solution—the Government would not claim it was, as right hon. and hon. Members have said—but it is a step in the right direction, although it will need to be refined in Committee. I will not go into why and how, because that has been amply rehearsed already, but it is important to consider some of the issues the Bill deals with: the availability of weapons; how easy or difficult it is for the police to deal with prosecutions; and the culture associated with this increase in violence, particularly among the young and in urban areas.

Our preoccupation with the here and now does not help. We have a culture dominated by the immediate at the expense of measured contemplation. We no longer think about what was or might be; we think of now, and we do not want people to feel that now is worse than it once was. Yet, having that long-term view and more contemplative approach to public policy is an important way to deal with some of the things I have described.

The idea that things are not getting better is unpalatable, which is why the Bill is pertinent and welcome. Crime has many causes, and some have been rehearsed in the debate. They include communal disintegration, family breakdown and the absence of opportunity, but fundamentally criminal behaviour is about the absence of values—values that the law-abiding take as read: care for others, personal responsibility, respect for the rule of law. In the absence of those values, the gulf is filled by altogether less desirable things—greed, anger, sloth, lust, gluttony, envy, pride. They are not, after all, new sins; they have been common to the human condition since man was made—and the results can be deadly.

Crime is not an illness to be treated, and the perpetrators of crime are not patients. Crime is the product of choices that people make. Those choices might have been affected by their circumstances, but it is pretty insulting to working-class people of the kind I was brought up among to tell them they are more likely to be criminals because they live on a council estate, work in a factory or never had a formal education of the kind I and many here enjoyed. Let us be clear: we have to identify malevolent behaviour and deal with it appropriately in the interests of public respect for the fairness of the justice system. Every time we do not, we undermine the regard for the rule of law among less well-off people—those hard-working decent people who do the right thing and do not choose the course of crime but go about their lives in a peaceable, decent and honourable way.

Let us now think about what more needs to be done. Certainly we need to tackle some of the “drivers” of crime, as they have been described by other Members. I have mentioned a few, in the context of health and the life of civil society, but I think that the internet is, or can be, a malevolent influence in this regard. We need to get tough with the social media platforms that glamorise violence, and, in particular, glamorise the use of the weapons of violence.

As I suggested earlier to the Home Secretary, we also need to adopt a cross-departmental approach to deal with support for the family and support for communities. The hon. Member for Sheffield, Heeley (Louise Haigh)—who I thought spoke extremely well, as I told her privately—mentioned early intervention. Early intervention does matter, and there is no better early intervention than a strong and stable family. My early intervention was my mum and dad, who taught me the difference between what was right and what was wrong. You can fudge these things, and you can have a high-flown debate in fancy terms about sociology, but in the end it comes back to that: people having a very fundamental sense of what is acceptable and what is unacceptable, and what is good and what is bad behaviour. Families really matter in that respect.

We know that there is an association—if I may get sociological for a moment—between certain kinds of young people and crime. They tend to be young people whose families have broken down, and who have not had the role model of a strong father. We need to take a lateral approach in considering some of those causal factors.

Finally—