Caroline Johnson MP: speeches 2024

Speeches

• 13 Nov 2024 · Environmental Protection · Hansard source

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  Does my hon. Friend accept that it is quite difficult for the consumer to establish which vapes are illegal and which are not? One may have thought that going into a reputable supermarket to buy such a product was a surefire way of ensuring that it was safe, but we have heard examples of major supermarkets selling a well known brand of vapes that had more in them than was legally allowed. If we ban disposable vapes, it will become very clear: all disposable ones will be illegal.

• 13 Nov 2024 · Representation of the People · Hansard source

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  The hon. Lady says that people have arrived to vote in somebody’s name and have been turned away and did not return when asked for ID. How can she be certain that they were the person they said they were?

• 12 Nov 2024 · NHS Dentistry: South-west · Hansard source

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  The Minister has iterated the problem, and he has spoken warm words about listening, talking and working with people. However, he has said little that is concrete, except about things that were happening already, either locally or as a result of the previous Government. With a minute left to answer all the questions he has been asked, can he commit to answering in writing those he does not have time to answer in the remaining minutes?

• 12 Nov 2024 · NHS Dentistry: South-west · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Vickers. I congratulate the hon. Member for Honiton and Sidmouth (Richard Foord) on securing a debate on this important subject, starting at the significant time of two-thirty—I thought that was particularly skilled of him. [ Laughter. ] I thought you would like that one, Mr Vickers. Nobody should have painful teeth and nobody should have difficulty accessing an NHS dentist. Lincolnshire, which is home to my constituency, suffers similar challenges with access to NHS dentistry; indeed, I led an Adjournment debate on the topic in October 2021. It has been pointed out that the number of dentists is not the issue; in fact, we have more dentists per capita than we did 10 years ago. Rather, dentists are either in the wrong place—concentrated in urban rather than rural and coastal areas—or they do not perform NHS work, for a variety of reasons. That leads to the underspend that has been described. There has been some progress, with 500 more practices accepting NHS patients as a result of the dental recovery plan, and 6 million more dental treatment processes completed in 2023 than in 2021-22. One thing that helped with that was the patient premium for new patients, who are more likely than repeat patients to have a problem with their teeth that requires treatment. They are also more expensive for dentists to treat, so the current contract disincentivises the seeing of new patients. The patient premium is funded until April 2025. Will the Minister say whether he plans to continue it beyond that date? Another help has been the golden hello of up to £20,000 for dentists working in underserved areas, including the south-west, the midlands and East Anglia. Will the Minister say whether that scheme will continue? A number of hon. Members have mentioned a long-term workforce plan. There are already additional dental training places in the south-west, but, as my hon. Friend the Member for South West Devon (Rebecca Smith) pointed out, there can be challenges in the way the training is organised, which means that people do not stay in the local area—although more do stay than if they had been trained elsewhere. Will the Minister look in detail at the problems my hon. Friend raised? Ultimately, we have more dentists than ever before, but private dentistry is much more lucrative than NHS dentistry, and the NHS contract is complicated, offers disincentives and needs reform. The previous Government began reforming the 2006 contract by increasing the UDA rate to £28 as a minimum. The Labour party had a manifesto promise to negotiate with the BDA. Will the Minister confirm if negotiations have started and, if they have not, when he expects them to start?

• 12 Nov 2024 · NHS Dentistry: South-west · Hansard source

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  It is unfair to say that there was no meaningful reform. There was reform, but it has not been enough to ensure that everyone gets a dental appointment, and we need further negotiation and reform. We can relitigate the election, but the Labour party won a majority for this term and it needs to use it to do what it promised. One of those things is reforming the contract, and that is why I am asking the Minister to tell us whether he has entered negotiations to do so. One thing the Government have done—this was brought up by the hon. Members for Mid Dorset and North Poole (Vikki Slade) and for Mid Sussex (Alison Bennett)—is increase national insurance contributions and lower the thresholds at which they are paid, which presents a challenge for dentists across the country. I know the BDA has written to the Chancellor to ask for an exemption, and I wonder whether the Minister can comment on that. I have tabled a number of written questions, and the answers I have received have been less than satisfactory; they are really not proper answers at all. The Government do not seem to have worked out how much they intend to mitigate the increase in national insurance contributions, for whom they might do so, or how much it might cost. That is clearly a great worry. The Health Service Journal published a leaked letter suggesting that the cost of the 700,000 extra appointments —and presumably, in many cases, the national insurance contributions—will have to be found within the current budget. The Department of Health and Social Care has suggested that the letter was never sent and therefore may be inaccurate. Will the Minister put on the record the reality of the situation? Will the funding be expected to come from the current budget, or will there be extra money—and, if so, how much? The Minister has said himself that water fluoridation is safe and effective and reduces tooth decay, so will he be adding fluoride to our water? He said in answer to a parliamentary question that he would do so “in due course”. Will he tell us what that means and how quickly he expects to do it? The Government have talked the talk on prevention; now they need to take action. The previous Government conducted a consultation on whether newly qualified dentists could be tied into working for the NHS for a period of time. What is the Government’s assessment of that consultation, and what do they intend to do about the issue? Supervised toothbrushing is an interesting plan, but what about children of other ages? What is being done to encourage parents to take responsibility for ensuring that their children’s teeth are cleaned? Armed forces families move around the country a huge amount, and our forces do an excellent job keeping us safe. The Conservative Government brought in the armed forces covenant to protect our armed forces and their families. What plans does the Minister have to ensure that families can access NHS dental care as they move around the country, and that they do not have to wait for a place only to not get one, and then move again and have the same problem? I think it was the hon. Member for Honiton and Sidmouth who brought up international dentists. An international dentist with equivalent qualifications can work in the UK privately, but they need to go through an additional process to work for the NHS and be on the performers list, which is unnecessarily complicated. What will the Minister do to ensure that, if a dentist is able to practise privately in the UK, they can also practise on the NHS—or does he think that is not the right thing to do? Other Members have mentioned fluoride varnish. Does the Minister have a plan to ensure that young children have access to that treatment? Finally, the Secretary of State for Wales has said that Labour will “take inspiration from Wales”. Given that dental activity is at 58% of pre-pandemic levels in Wales, compared with 85% in England, and that 93% of practices in Wales—a greater proportion than in the rest of the UK—are not taking on new adult NHS patients, will the Minister reassure us that that is definitely not the case?

• 6 Nov 2024 · Budget Resolutions · Hansard source

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  I do. As a farmer’s wife, I particularly recognise the effort of families to work together on farms. It is not the most profitable work, but is a labour of true love. Those who need a pint after listening to all the increases in taxation across the generations may be pleased to hear that pints are going to be a penny cheaper—woo-hoo—but with business rates relief for pubs and other hospitality having gone from 75% to 40%, and the rise in the minimum wage and in national insurance contributions, the likelihood is that prices will not go down at all, leading to further disappointment. The Budget is bad for business, bad for growth, bad for the young and bad for the old. But most of all it is a break of trust. It is a litany of broken promises from the Labour Government to the public. Labour voters, like the Prime Minister’s favourite singer, may be saying to themselves, “Did you have to do this? I was thinking that you could be trusted.”

• 6 Nov 2024 · Budget Resolutions · Hansard source

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  My right hon. Friend is making a characteristically excellent speech, and he mentions the transport projects that have been scrapped. We have not heard about what is happening to the North Hykeham relief road in my constituency. Does he agree that investing in roads in this way creates growth?

• 6 Nov 2024 · Budget Resolutions · Hansard source

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  Is the reality not that the Labour Government also do not know how they will balance the books? I asked the Secretary of State for Health and Social Care in a written parliamentary question how much the rise in employer national insurance contributions will cost the Department. The Government said that they did not know.

• 6 Nov 2024 · Budget Resolutions · Hansard source

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  I declare that I have a financial interest in some of the Budget measures. The Budget is one of broken promises and poorly thought out measures for every generation. For children who attend private schools, their schools will face VAT. Quite apart from the disruption that will cause, it is unlikely to raise the money the Government suggest, because the wealthier parents have already paid, more students will need to be looked after in the state sector, there will be greater demand on SEND services and there will be a reduction in employment among staff who previously worked at such schools. The Prime Minister told those who go to university that he wanted to abolish tuition fees. I wonder whether they are surprised that he has put them up. Young people wanting to buy their first home will see stamp duty thresholds fall, and many more will pay stamp duty on their first home. What of those working people the Labour party has found it so difficult to define? First, they have to get to work. Those who use the bus will find that the fare has increased by 50%. Those who have commercial pick-up trucks will see that the tax on them has gone up too. What about the national insurance rise? It is a tax on every single working person and it has not been thought through, as public sector workers will also need to pay the national insurance. The Government said to The Times that they were going to provide mitigation, but the Department of Health and Social Care does not seem to know how much it is going to cost to start with. I asked a written parliamentary question and was told it will take longer to prepare an answer. The Department does not seem to know how much it will cost directly or indirectly. Many right hon. and hon. Members have talked today about the indirect costs that will face air ambulances, hospices, general practices, opticians, care homes, mental health services and outsourced laundry, catering and human resources. What about the private hospitals delivering waiting list initiative work for the NHS? They will also need to put up prices. Will the nurse who works at a private hospital doing a proportion of her or his work for the NHS and a proportion for private enterprise be partly recompensed, or not? It has not been properly thought through. We will need the NHS for all those old people, cold and vulnerable in their homes, who have had the winter fuel allowance snatched from them—people the Labour Government have let down. If they die, they have the prospect of further taxation on their pensions, business assets and family farms.

• 6 Nov 2024 · Budget Resolutions · Hansard source

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  I thank my right hon. Friend for the speech that he is making. Does he agree that many of those people will now feel betrayed?

• 4 Nov 2024 · Budget: Implications for Farming Communities · Hansard source

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  I declare that my husband is in agriculture and farming, and therefore I have an indirect financial interest in the topic. This Government promised that they would not raise national insurance contributions, but they have. They promised that they would not reduce agricultural property relief, but they have. They have also added a fertiliser tax and a tax on pick-up trucks as a way of compounding the misery. Has the Minister done an impact assessment on food security and food prices following the Budget, and will he publish it?

• 30 Oct 2024 · Children’s Hospices: Funding · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Twigg. I congratulate the hon. Member for Liverpool West Derby (Ian Byrne) on securing this important debate and on his work to raise funds for this important cause. I will look on YouTube later to see whether I can find the right hon. Member for Hayes and Harlington (John McDonnell) playing the trombone; I am sure it will be a great rendition. Losing a child is every parent’s very worst nightmare, but every day parents throughout the country are caring for children with life-limiting diseases. There are now 99,000 seriously ill children and their families in the UK. For those families the children’s hospices are, as we have heard today, a necessary lifeline. As an NHS consultant paediatrician, children’s palliative care is an issue close to my heart and I have cared for many children with life-limiting illnesses. I have also been the person who has delivered that bad news and been there through families’ journeys, and also in those final moments. My role as a politician now gives me the opportunity to stand here and advocate for those families and those children, and to use this platform as a vehicle for positive change to make the treatment and care for those children much better. It is an opportunity I have taken before. I was pleased to hear my hon. Friend the Member for Bromsgrove (Bradley Thomas) and my right hon. Friend the Member for Aldridge-Brownhills (Wendy Morton) talk about Acorns hospice. In 2019, the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) and I co-chaired the all-party parliamentary group for children who need palliative care, and heard of the financial difficulties faced by Acorns and other hospices. Our campaign, and an Adjournment debate held in July 2019, led to an announcement from the Minister at the time, my hon. Friend the Member for Gosport (Dame Caroline Dinenage), that the hospice grant would be doubled from £12 million to £25 million. That certainly helped the hospices then, but time has moved on. Demand is increasing; there are more children affected, sadly; those children are living longer, which means they need the services for longer; and the complexity of the care they require has increased. In fact, on average, children’s hospices in England spent 15% more in 2023-24 compared with 2021-22. Charities have raised money to fill the gap, but we have heard that they find it more difficult to raise funds in some areas than others, depending on the relative affluence of the people who live in the area surrounding the hospice. That relates not to their generosity but simply to their means to provide extra funding. It is important that we ensure that all children have access to such services, regardless of where they live. Progress was made in the previous Parliament on improving access to palliative care for children. As part of the Health and Care Act 2022, the Government added palliative care services to those that must be commissioned by the ICB. As part of that, £1.5 billion of extra funding was provided at national level to support ICBs with inflationary pressures, and a further £25 million was allocated in grant funding for the 2024-25 period. However, it is important to say that we still have increasing demand and we still need more funding. We also need certainty, as hospices cannot plan from year to year. They need the Government to give them the sort of certainty of financial support that they were given previously. I am concerned about the Budget this afternoon, because we have been briefed that national insurance contributions for employers will rise. We have also been briefed that NHS direct employers will be protected, but that will not necessarily protect hospices and others who deliver healthcare services. We will look carefully at that this afternoon. As I said, the ICBs are now responsible for allocating funding for children’s hospices, but Together for Short Lives has highlighted the variation in how they have allocated that grant. Some have paid the allocation in full, some are paying it quarterly and others have not paid at all. What steps will the Minister take to hold the ICBs to account for allocating the grant and supporting hospices? I recognise that there is great value in the ICBs providing local services, locally commissioned, to best target local services at the population they serve, but there is also a recognition that some services are low volume but high complexity and best commissioned nationally. I urge the Minister to consider carefully whether the balance is right for children’s hospices, which are certainly relatively low-volume, high-complexity services, and whether they should be nationally commissioned. In either case, it is wrong that ICBs do not have access to the statistics showing the number of children they have to care for, because without them they cannot plan their funding. I ask the Minister to do what he can to ensure that he has the right information to make the right decision. Many children with life-limiting conditions have cancer. The children and young people cancer taskforce was set up earlier this year to drive improvements in how we detect, treat and care for children with cancer. What is the Government’s alternative to the cancer taskforce, which has been paused, and how quickly can we expect it to be put in place? I appreciate that it is difficult for the Minister to make commitments, given that the Budget is just a few hours away, but will he commit to reviewing the locations of children’s hospices? A report produced by the APPG for children who need palliative care—including the hon. Member for Mitcham and Morden (Dame Siobhain McDonagh)—in conjunction with Together for Short Lives demonstrated that because children’s hospices are often set up charitably, their locations are not always spread evenly across the country, so particularly in rural areas people find it difficult to access one. Given that all children must have access to hospices, will the Minister commit to at least looking at how to ensure that access? Will the Minister restate the Government’s commitment to the provision of short breaks? Children’s hospices provide excellent palliative care at the end of life, but they also provide significant care during life. Part of that is short break respite care, which is so valuable to many families. Will the Minister commit his Department to ensuring that is funded?

• 30 Oct 2024 · Children’s Hospices: Funding · Hansard source

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  The Minister talked about maintaining the grant, but does he recognise that many hon. Members have also raised the increasing costs that hospices are facing? Will he look to not just maintain the grant but increase it?

• 22 Oct 2024 · Draft Human Fertilisation and Embryology (Amendment) Regulations 2024 · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Mundell. The Opposition will not object to the draft regulations, particularly because they were drafted by the Conservative Government and introduced by my former colleague, Maria Caulfield, who was then the Minister. They were announced last year and were laid earlier this year. However, I have a couple of questions. The draft regulations mention donations from family members. Given that we know that infants conceived where both biological parents have close family relations are at higher risk of genetic and other medical conditions, will the Minister update us on any specific guidance on the use of the word “family” in relation to who can donate? Will he confirm that the NHS will still screen all donations for HIV? The Minister said that there are no implications for the NHS. Does that mean that shared motherhood will not be provided for by the NHS or that the NHS will not provide services to those who are HIV positive, or does he expect the numbers to be so small that it will not make any difference? Finally, he said that the provisions are being brought forward in Northern Ireland under the Windsor framework and the EU withdrawal Act. Does that mean that he considers the ability to bring in these regulations to be a benefit of Brexit?

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  As a doctor myself, I wish to start by recognising the substantial work ethic and expertise of my primary care colleagues and thank them for all that they do. Saying what is wrong with the NHS is very easy; solving problems takes much longer and is far more difficult. Rather than the next few hours being filled with constructive ideas, I expect that we will simply hear complaints about the challenges faced by the NHS, perhaps some party political jibes and a wish list of promises and the things that people want to see, but no concrete plans on how to deliver them beyond more money. I hope that I am wrong about that, but I suspect that I am not. Our NHS is facing significant challenges. We have an ageing population with more complex health needs, a rising demand for services and a rapidly growing population. We also have the legacy from the pandemic, which many are quick to forget. Although we were the first country to deliver a vaccine, there are many persistent problems stemming from the pandemic. Let me give the House an example. Before the pandemic, in 2019, there were 54 women who had been waiting more than a year to see a gynaecologist, but due to the reduction in elective activity during the lockdown, by the time the pandemic was over that number was more than 40,000. This is, of course, replicated across other medical specialties. Although my secondary care colleagues have been working extremely hard to reduce those numbers—and, indeed, they have fallen—the individuals concerned will, on average, visit their GPs more while they are waiting and that inevitably puts more pressure on primary care services. The simple truth is that we gave the NHS more money than it has ever had and, as a result, it has delivered more clinical activity than ever before, but the ageing population, the rising demand for services and the legacy of the pandemic have meant that, in places, that has not been enough. Many people are not being seen as quickly as we would want them to be. The previous Labour Administration did not do enough to train new doctors, and the reality is that we cannot train one overnight. The Conservative Government built five new medical schools, and the graduates of those medical schools have recently started work. The Secretary of State says that he will double the number of medical students. That is an item on his wish list with which I agree, but I do have a few questions. Will he build new medical schools, expand the old ones, or do both? If he is going to build new ones, where will he build them? [Interruption.] The Minister for Secondary Care is talking about primary care. I believe that doctors are a part of primary care. The UCAS deadline to apply for most medical school places to start next autumn was yesterday, so when does the Secretary of State expect these new places to be available and those new students to start? On the broader primary care workforce, we expanded the number of primary care professionals in GP practices, such as dietitians and physiotherapists, and we delivered 50 million more GP appointments last year than in 2019. We also saw the launch of Pharmacy First, which delivered more care in the community while easing pressure on GP appointments. I was pleased to hear the Liberal Democrat spokesman acknowledge the success and the benefits of that programme. I have a few questions for the Secretary of State. The Conservatives produced the first NHS workforce plan. Can the right hon. Gentleman say whether he will proceed with those plans or write a new one? What are the timescales for his plan? In the spring Budget, we had the NHS productivity plan, with £3.4 billion to improve NHS productivity. Does the right hon. Gentleman still intend to follow that? The Minister for Secondary Care said that she was recruiting 1,000 GPs. Can the Secretary of State tell us how many have been recruited so far? The Secretary of State and I also agree on the ability of technology to improve NHS services.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  I thank the hon. Gentleman for his intervention. I have talked about the challenges the NHS faces. I will come shortly to the achievements of the Labour Government so far in the Department of Health and Social Care. Turning back to technology, I was saying that I agree with the Secretary of State on how technology can improve NHS services. Over the last few years, in my professional capacity, I have seen improvements in making communication between primary and secondary care and within secondary care much more efficient. As a patient, I have used the askmyGP service, which is an excellent way to communicate with a GP, particularly for working people. I have also used the NHS app, which millions of people have downloaded and which has huge potential. I hope he intends to build on that potential and harness the benefit of AI for diagnostics in particular. The Secretary of State and I also agree on the importance of prevention. It is vital to make the NHS accessible to those who need it, but it is even better if people stay healthy in the first place. Before the election, he was supportive of measures to protect children from the dangers of vaping—measures I campaigned for actively. In fact, he was quite critical that it had not been done sooner, as in some respects was I. Given that the legislation has already been written and that it passed both Second Reading and Committee stage with the support of his friends on the Labour Benches, why is it taking him so long to produce a tobacco and vapes Bill? Can he guarantee that he will deliver it, like a present, in time for Christmas—for clarity, I am hoping for this Christmas?

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  No, I will not give way again, because I know that you will give me eyes if I do, Madam Deputy Speaker. Labour has spent 14 years in opposition. The Secretary of State has had plenty of time to consider what he would do if he gained office, so, further to the intervention of the hon. Member for Chelsea and Fulham (Ben Coleman), what have the Government achieved in 14 weeks to help the health of the nation? I will tell you, Madam Deputy Speaker. They have opened the Department’s doors to their Labour mates. They have awarded an inflation-busting pay rise to junior doctors without negotiating any modernisation or productivity reform in return. They have overseen GPs entering industrial action and nurses rejecting their pay offer. They have scrapped the social care costs cap. They have produced a report of selected statistics with no policy recommendations. They have broken their manifesto pledge to deliver the new hospital programme. They have taken the winter fuel payment from millions of vulnerable pensioners. They have even stopped the children’s cancer taskforce. That dire record, underlined by the Labour legacy in Wales, fills me with huge trepidation for the future of the NHS. I hope that when the Government’s plan eventually comes, it is a good one, for all our sakes.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  Essentially, because there is more clinical acute need in primary care hospitals. Given the choice, with one amount of money, between saving a life and preventing a problem for later, it is inevitable that money gets shifted towards acute care. That is where the pressure is, but I agree with the hon. Gentleman that we need to work harder to prevent people from becoming ill in the first place.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  I have been a good girl, thank you, Secretary of State. Furthermore, can the Secretary of State explain how cancelling dozens of new hospitals will reduce pressure on general practice? Can he explain how cutting the winter fuel payment for millions of pensioners will help the NHS? The End Fuel Poverty Coalition predicts that Labour’s winter fuel payment cut will result in an additional 262,000 pensioners needing NHS treatment because they are cold, resulting in a great deal of suffering and millions of pounds of additional cost to the NHS. Does he agree with that assessment? I have asked repeatedly, in both oral and written questions, if the Government will conduct a proper impact assessment of the policy on the NHS and on the wellbeing of vulnerable older people. Will he commit to producing and publishing such as report? Further on the issue of prevention, the right hon. Gentleman will know that folic acid supplementation can prevent neural tube disorders, such as spina bifida and anencephaly. The previous Government brought forward regulations on the matter. What conversations has the Secretary of State had with the Department for Environment, Food and Rural Affairs about ensuring that that work is continued? Our approach to dentistry was also underlined by prevention. We introduced the Health and Care Act 2022, which gave the Secretary of State the power to introduce water fluoridation schemes. Those powers have since been used to extend existing schemes, particularly in the north-east of England. Does the Secretary of State intend to continue that work and exercise the powers the previous Government gave him? He knows that I am passionate about dentistry. I have raised the issue many times in the House, including by securing an Adjournment debate on dentistry in Lincolnshire. It troubles me greatly that children are coming to hospital for multiple dental extractions due to rotten teeth. It is worth noting that the issue is not a shortage of dentists overall or, as the hon. Member for North Shropshire (Helen Morgan) says, a shortage of money, but a shortage of dentists doing NHS work rather than private work specifically. The previous Government were encouraging dentists to take up NHS work with a range of measures, including golden hellos for dentists in underserved areas, dental vans going out to rural communities, and tie-ins for new dental graduates. We were also in the process of broader contract reform after a small change in the units of dental activity rate when we went into the election. Let us look at Labour-run Wales in comparison. Wales is delivering only 58% of pre-pandemic dental activity. It is burdened with the highest proportion of NHS dental practices not accepting adult patients and the longest waiting lists in the UK. One in four Welsh residents is currently on a waiting list. The new Secretary of State for Wales has said that the Government “will take inspiration from” Labour-run Wales on dentistry. Given their woeful record in office, I sincerely hope that that is not the case. Before the election, when I listened to the Secretary of State for Health and Social Care say that Labour had a plan to reform and modernise the NHS, I believed him, but in Monday’s debate on the Lord Darzi report, we uncovered that his plan was not really a plan at all, but a list of desired outcomes and a proposal to make a plan if he got into office. It is unclear how long this plan will take to develop. The Minister for Secondary Care said that it is a listening exercise like we have never seen before, but how much will that cost, and had Labour not been listening already?

• 15 Oct 2024 · District Hospitals · Hansard source

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  We have heard about the challenges facing Whipps Cross hospital. The Secretary of State’s decisions to pause capital projects across the country and put them under review has caused worry and uncertainty for staff in hospitals nationwide. Can he say when the review will be completed, so that we have certainty about when things will go ahead?

• 14 Oct 2024 · Reporting Ministerial Gifts and Hospitality · Hansard source

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  Government guidelines for the self-employed are very clear: “You cannot claim for everyday clothing (even if you wear it for work).” Yet we have heard that Cabinet Ministers declared clothing donations as donations in kind for undertaking parliamentary duties and, further, “to support the Shadow Chancellor’s office”. Does the Minister think that these were transparent donations, or were they designed to deceive?

• 14 Oct 2024 · Afghan Special Forces Relocation Review · Hansard source

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  I understand that, as a result of the ARAP programme, there will now be a new temporary centre to receive families at Beckingham camp and training ranges in my constituency. This fairly isolated site, consisting of Nissen huts, is normally used by cadets and personnel practising on the ranges. How long will the individual families be expected to stay in these Nissen huts? What money will be given to local authorities to ensure that people can be properly cared for while they are there? And how long does the Minister anticipate this temporary centre being open before it is returned to military use?

• 14 Oct 2024 · Gibraltar-Spain Border Checks · Hansard source

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  The right hon. Lady talks about the negotiations, but the problem is that the Government do not have a great track record on negotiations. What did they get from the train driver negotiations but a lot of very cold pensioners? What did they get from the negotiations on the Chagos islands? They appear to have given away sovereign territory and paid for the privilege. How can we trust this Government with the safety of Gibraltar?

• 9 Oct 2024 · Sepsis Awareness · Hansard source

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  It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Ashfield (Lee Anderson) on securing a debate on this very important topic. I should also declare an interest as an NHS consultant paediatrician. I have cared for and continue in my work to care for people with this condition. I would like to thank Abbi for coming today. It was an honour to meet earlier today and to hear her story from her MP, which highlighted both the difficulties she faced in getting good immediate care for sepsis and the consequences of that. I commend her for the bravery she has shown in coming today and for raising this issue for the benefit of other people. This debate will increase awareness, which is a very positive thing. I remember sitting in the Chamber earlier this year when the former hon. Member for South Thanet re-entered Parliament to a standing ovation—an exceptionally rare occurrence in the House of Commons. It is truly humbling to reflect on the journey that he has been through in such a short space of time. Little over a year ago, he had no outward signs of sepsis at all. He has now become one of the most well-known advocates for people with it. His case brought renewed attention to this disease, which kills nearly 50,000 people in the UK every year. As the hon. Member for Ashfield said, that is around the same number of people who die from bowel, breast and prostate cancer combined. The case of our former colleague speaks to not only a remarkable recovery but the suddenness with which sepsis can utterly change someone’s life. As many people have said today, early identification is vital. Under the previous Government, awareness of sepsis improved significantly, as did the clinical recognition of symptoms, screening rates and the administration of antibiotic treatment, but there is much more to do. I want to commend the UK Sepsis Trust and other public campaigners who played a significant role in improving awareness among the general public. A recent YouGov survey showed that the UK has high levels of public awareness compared with other countries. Will the Minister say what steps the Government will take to work with NHS England and patient groups such as the UK Sepsis Trust to raise public awareness, so that people can more easily identify the signs of sepsis? I have also asked this of another Minister, but have not yet received an answer. The Chancellor said that she was cutting the communications budget—can the Minister confirm that those cuts will not affect the important public health messaging for campaigns like this? It is important that we do not cut budgets that will save people’s lives and, indeed, save the NHS money. It is also important to raise awareness not just across the general public, but among health professionals, including medical staff in both hospitals and communities. The national early warning score has been introduced and is being rolled out, along with the sepsis six, which was developed with the UK Sepsis Trust. The six—oxygen, cultures, antibiotics, fluids, lactate management and urinary output monitoring—must all be carried out within the first hour. Has the Minister established how well those measures are being rolled out across the UK, and what is he doing to ensure that is being done effectively? The National Institute for Health and Care Excellence updated its guidance earlier this year. Will the Minister update the House on how effectively that guidance has been implemented across the UK? Martha’s rule was introduced before the election; the rule relates to the ability for people to get a second opinion from another health professional if they remain concerned about their loved one or themselves. Will the Minister update the House on the work the NHS is doing to roll that out, too? Research is the cornerstone of transforming sepsis care, and the last Government invested more than £1 billion through the National Institute for Health and Care Research. It is important that we research the causes of and treatment for sepsis, but we must also research new antibiotics, because we are starting to see antibiotic resistance to infections. If we do not invest in antibiotic research, new antibiotics will not be developed—we are essentially asking people to develop a drug to be kept on the shelf for when we need it, and there is no money in that, so it will not get commercial take-up. It is therefore important that the Government invest in that. The UK Sepsis Trust is calling on the Government to publish data on the sepsis care pathway so that we can see where it is performing well and where it is performing less well. I urge the Government to do that. It would be helpful if the Minister could confirm today that they will do so. As we close the debate, let us remember what we are fighting for. Sepsis takes the lives of 50,000 people every year. It strikes suddenly and often without warning, as Lord Mackinlay’s case reminds us so powerfully. Early identification and rapid treatment are the keys to saving lives; we have made strides, and awareness is growing, but we must do more. We must continue to improve recognition, strengthen control and push forward with life-saving initiatives. I urge the Government today not just to maintain their commitment but to strengthen it by partnering with NHS England, publishing more data, researching the causes of sepsis and ensuring we can fight this disease together.

• 9 Oct 2024 · Maternity Services: Gloucestershire · Hansard source

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  It is a pleasure to serve under your chairmanship, Sir Christopher, and I congratulate the hon. Member for Cheltenham (Max Wilkinson) on securing this important debate. Childbirth is a really special event. It has been described today as the best moment of someone’s life, and that description is often used. It is a special moment in the lives of not just the parents and of course the child, but the wider family and friendship group—the birth of a baby is enjoyed by everybody. I have been privileged to attend many births over my career as a doctor, although aside from the births of my own three children, they have generally been skewed towards where things have not been going to plan—it is not, I hasten to add, that that is a result of my presence, but more that my presence is a result of things not going to plan. The work of the NHS—its midwives, its obstetricians and the wider team that look after women and their babies—is by and large exceptional. However, we hear stories of where things go wrong and we need to minimise those as much as possible. Essentially, the talk of whether Cheltenham needs a midwifery centre comes back to the pull and tug that I have seen throughout my career between the centralisation and the localisation of services in general. When services are centralised, it can be argued that there is an increase in expertise and an increased volume of cases, which makes people more familiar with emergencies because they happen more frequently. More specialist services can also be offered for those with high-complexity and low-volume problems. There can also be more support from staff, because there are more staff present in the unit. However, centralised services can feel more remote, they can be too far away for people living in rural areas and they can feel too impersonal, particularly for a procedure such as giving birth. In a local unit, people may feel more comfortable and know the staff, and there may be a close-knit team. However, as our veterinary colleague, the hon. Member for Winchester (Dr Chambers), so amply described, if things go wrong, people can be a long way from the help they need. So there is that balance and that push and tug. As has been mentioned, choice is important to women who are making informed consent choices on where to give birth, based on the information they receive. The hon. Member for Cheltenham has made a good case for why the balance may not be as it ought to be in Gloucestershire; the Government should look carefully at that. I was sorry to hear of the experience of the hon. Member for Gloucester (Alex McIntyre) with his new-born baby. As a paediatrician, I am familiar with the need to weigh all the factors in the balance: the fact that a baby has gone home and may have picked up a viral illness that has brought them back in again; the risk to the baby from going on a children’s ward where the impact of disease is more predominantly based in infection and infectious conditions than in older age groups and adult wards; and the risk of putting a baby on a neonatal unit and introducing the virus to that unit, which could make the babies already there so very unwell. We need to think carefully about a solution to that, so that people do not go round and round in circles, as the hon. Member for Gloucester described, being passed from pillar to post. I am sure that was a frightening experience for him and I am sorry that happened. I now turn to other issues raised today. The hon. Member for Stroud (Dr Opher) talked about the importance of community midwives. Even though my eldest is now 17 and my youngest nine, I still remember my post-natal midwife Marie and the care she gave. Sometimes, maternity care focuses a little too much on what is going on in a hospital when what happens in the community is also very important. The hon. Member for Thornbury and Yate (Claire Young) suggested that we could have a midwifery in-patient unit with mothers and babies and only one member of staff. I am afraid I do not agree with her on that. The hon. Member for Winchester raised the concept of two simultaneous emergencies. If there is only one member of staff, how do they go on a break, or what if they are in the bathroom when they are needed? If we have a unit, unless it is attached to a major centre with more staff, we need that second person. As of December 2023, there were 2,361 full-time equivalent midwives working in the NHS’s trusts and other core organisations in England. That is an increase of 3,707—18.9%—since 2010. On the one hand, the birth rate is falling and the number of midwives is rising, but I recognise that the births that are taking place are more complex in some ways than they used to be. At the spring Budget, there was a further investment of £35 million to improve maternity safety over the next three years, including £9 million for brain injury. I asked the Minister, at the previous debate on maternity safety on 4 September, whether she would commit to that money being spent and I have not received an answer. I asked her several questions during that debate, including whether she could confirm that the Government would proceed with the fortification of bread products with folic acid to protect babies from spina bifida. I asked her about the non-essential communications budget, which the Chancellor had said on 29 July would essentially be cut, and whether that was affecting public health budgets. Those budgets are very important, particularly around optimising public health messaging regarding chronic illness and conditions such as diabetes and obesity before conception. I have not received an answer to either of those questions. I also raised the NHS saving babies’ lives care bundle, which was due to be updated on maternity early warning scores and tracking tools, to ask the Minister whether that was on track. Again, she has not written to me as promised with the answer to that question. I asked her whether she would be supporting the healthcare safety investigations branch and about the £35 million budget I have just described. I have not received answers to any of those questions more than a month later; none of my staff can find any correspondence from the Minister. Can she answer those questions today, or at least commit to doing so by the end of the week? We have waited quite a long time. My final question last time was about the group overseeing maternity services nationwide, because following the East Kent report—I was the Minister when that was published—Dr Kirkup’s recommendations were accepted. Maria Caulfield, then Minister for Women’s Health, set up and chaired a working group to review the work being carried out by a whole range of programmes to improve maternity and neonatal care and implement those recommendations. I asked her who would go on to chair the group and whether she could guarantee that the work would continue, but I still have not received an answer. It would be helpful for the Minister to answer the questions raised in the last debate as well as in today’s.