Local Contact Tracing

Alex Sobel Excerpts

Wednesday 14th October 2020 Commons Chamber

[Rachel Reeves]

Local councils are desperate to take on the responsibilities from Serco. They are begging the Government: “Hand over the resources and the responsibilities, because we can do it better than you.” I will come later to the issues relating to what the Government are doing with tier 3 compared with the other tiers.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My hon. Friend and parliamentary neighbour is making an excellent speech. If local authorities undertake similar procurement, they have to utilise best value and have a social value framework. If they conducted procurement as the Government have, the Government would bring in commissioners. This is an absolute scandal.

[Rachel Reeves]

I could not agree more. My hon. Friend will know that in Leeds, which we both have the privilege of representing, with the expertise we have on the ground, our local authority and director of public health could be doing a much better job than Serco is doing. Indeed, when we have had local outbreaks in Leeds, it has been the local authority going out and knocking on doors to ensure that people know what is going on—something that Serco cannot or does not do.

Covid-19 Update

Alex Sobel Excerpts

Tuesday 5th May 2020 Commons Chamber

[Matt Hancock]

Yes, of course; if I get the details, I am very happy to do that. I would also be very happy to know where my right hon. Friend had his hair cut, because it is extraordinary. No one else has such smart hair. Everyone is looking increasingly bushy.

[Alex Sobel (Leeds North West) (Lab/Co-op) [V]]

Dozens of dentists have got in touch with me, saying that the measures put in place are not protecting them and their practices. They take on a combination of private and NHS patients. Many are fearing bankruptcy and, ultimately, closure. This will leave NHS dentistry in an existential crisis. What steps is the Secretary of State taking to ensure that NHS dentistry survives the current crisis?

Covid-19

Alex Sobel Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

We are trying to address the precise point of the supply of medicinal cannabis products through a change to the Home Office regulations anyway. The advice is against unnecessary travel, and the sort of travel that the hon. Gentleman describes sounds very necessary to me.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

Later, at the height of the crisis, the Secretary of State will be judged on the answers he gives today. At the beginning of the crisis, there were estimated to be only 5,000 ventilators in the NHS. Can he tell us exactly how many ventilators he has purchased, what the modelling says about how many ventilators will be needed at the height of the crisis, and whether we will be able to get everybody on a ventilator at that point?

[Matt Hancock]

As the hon. Gentleman knows from my previous answers, that is not the way we are addressing this question. The way we are addressing it is that we will buy as many ventilators as are made. It is not a question of putting a target on it. We are just going after as many as we possibly can.

Coronavirus

Alex Sobel Excerpts

Wednesday 26th February 2020 Commons Chamber

[Matt Hancock]

I thank my hon. Friend; I will certainly do that. I agree with him on the importance of mitigation. The mitigation strand is really about what would happen should this become a full-scale pandemic, and the very significant impact that that would have on the country— including, of course, on the NHS. On the purpose of the delay strand of this work, even if we do not succeed in containing the virus, we want to delay its arrival so that it does not all arrive in one big peak, but arrives over time so that we can better cope with it. Of course, the contain strand is about trying to stop that from happening at all.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

As the House knows, I was in self-isolation last week because Harry Horton of ITV alerted me to the fact that there had been a confirmed case at the UK bus summit, which I attended. I rang 111 and the advice was that, if I had been in contact with the person who had coronavirus, I should self-isolate, but if I had not, I need not. Yet no agency could confirm or deny whether I had been in contact. So more work on tracking needs to be done. Will the Secretary of State consider developing, like the Chinese Government, a tracking app to help people in that situation?

[Matt Hancock]

I am very happy, subject to consent, to look at that. I would also say that the way that contact tracing works is that, once the positive case is identified, you trace out from the positive case, rather than starting from the wider population—including attendees at the bus conference—and focusing in. Contact tracing was undertaken in the correct way. Indeed, the majority of cases that we have found in the UK have been found through the proactive contact tracing undertaken by Public Health England; that commends its approach.

Acquired Brain Injury

Alex Sobel Excerpts

Thursday 6th February 2020 Westminster Hall

[Chris Bryant]

Interestingly, I had a phone call yesterday morning with Dawn Astle, the daughter of the famous footballer Jeff Astle, who was particularly renowned for heading the ball. I am a Welshman, and we have been boycotting the World cup for very long time—certainly the finals, anyway—so football is not my area of expertise. However, something I have been particularly disappointed about since the APPG produced its report “Time for Change” is that, even though we have been making recommendations about concussion in sport for quite some time, the Government want to wash their hands of it.

There is legislation in every state in the United States of America about sport’s duty of care to participating individuals. Sport is good for you; playing football, rugby and all these things are good for you. I do not want to mollycoddle or wrap anybody in cotton wool, but there may be subtle changes that one can make to each sport to prevent unnecessary damage to people’s brains. Also, I still think that there has not been a cascade of information and understanding of concussion from the professional medics in the organisation down to the grassroots of each sport. That will happen only when there is a shared set of protocols for all sport.

There is clear evidence that a professional footballer is three-and-a-half times more likely to suffer from dementia. There is lots of evidence to suggest that that is to do with heading the ball—not the weight of the ball, as may people say, but the physical process of heading the ball, because it pulls the brain from one side and hits it on the other, which leads to a significantly increased risk of dementia. It seems bizarre that that is not thought of as an industrial injury, which football needs to look at seriously. It also seems bizarre that, at the very highest level of football, a footballer who is taken off to be tested for concussion cannot be replaced, and that player gets only three minutes, which is nowhere near enough time for a proper analysis of whether somebody has suffered concussion.

Football still has some considerable way to go. The Department for Digital, Culture, Media and Sport must play a role in bringing all the sports bodies together round a table to analyse this problem. Otherwise, sports will end up facing massive court cases and very big fines, as has happened in the United States of America. I would prefer us not to go down that route.

There is a spectrum stretching from those who have suffered the worst traffic accidents or have had a severe stroke to those who have had a minor head injury and have lost consciousness for less than 15 minutes. Incidentally, there is a lot of misunderstanding about what losing consciousness and concussion means—I will not go into that, but there are different parts of the brain that might be affected.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My hon. Friend is making an excellent speech. Regarding road traffic accidents, there is a spectrum of vulnerability, and cyclists are some of the most vulnerable road users. There have been many studies about the efficacy of cycle helmets. The Cochrane review found that using a cycle helmet reduces the likelihood of brain injury by up to 88%. Should the Government not do more to encourage the use of cycle helmets for cycle safety?

[Chris Bryant]

I will not go beyond my area of expertise, so I hope my hon. Friend does not mind that I hesitate to respond. I have read the piece of work that he refers to, and he is right. Other work suggests that there are other things we must do to ensure that cyclists are safe. We need a mixture of all those measures because in future more people will cycle, and we do not want that to lead to a significant increase in road traffic accidents.

The one thing I must praise the Government for, though, is the development of the major trauma centres in England. Despite in many cases not being particularly popular, because it has felt like a service is being made less local and a more regional centre of excellence, the centres have undoubtedly led to at least 1,000 extra lives being saved every year. I praise the Government for their work on that, and I am glad that we will have something similar in south Wales soon. I will not go into the issues about the accident and emergency unit at the Royal Glamorgan hospital today.

The downside of saving lots of lives is that there is a duty of care to provide the neurorehabilitation needed to ensure that those people have a decent quality of life. It is perfectly possible to do that, but at the moment a quarter of major trauma centres do not have a neuro-rehabilitation consultant. There has been significant progress in relation to neurorehabilitation prescriptions. When I last raised that subject, the Government said that around 90% of people were receiving such prescriptions, but whether they are going to the individual and their families, to ensure that that can be pursued, or whether those prescriptions remain with the doctors only, I do not know.

If the Minister looks only at one specific issue, I am keen she looks at how patients get written to. Some doctors, such as consultants, always write to the patient’s GP or other doctor, sometimes in highly technical language. Some local health trusts copy that letter to the patient, but some doctors are now doing something far more effective—certainly far more effective in this area. They are writing not to the other doctor, but to the patient and copying that to the doctor. Of course, they have to use language that the patient can understand, but it is about empowering the patient. One message that I have heard more than any other from many patients and families I have talked to is that they feel completely powerless. Lots of other people are making decisions about them, but they do not understand how those decisions have been reached. They do not know whose door to knock on—or whose door to knock down for that matter—to ensure that their loved one gets the care and support they need. I wonder whether turning those letters on their heads so that the doctor writes to the patient, putting that information in their hands and empowering them, and similarly giving the prescription to the patient and family rather than to somebody else in the medical establishment, would not have a profound cultural effect.

I want to talk briefly about prejudice, because a degree of prejudice is another thing that sometimes comes with a brain injury. Perhaps the person in front of us in the queue in Morrisons or Sainsbury’s or wherever is slurring their words. It is all too easy to get judgmental and think, “Oh well, they’re drunk, and it’s only eight o’clock in the morning,” or whatever, but it might be because they have had a brain injury. It is great that work has been done on the London underground—it needs to be rolled out across the whole country—to explain that some disabilities are not visible, so we should suspend our tendency to be judgmental. We should probably suspend it more often in life generally, but we should do specifically in relation to potential disability.

In commenting on a story from earlier this week, I make absolutely no criticism of my hon. Friend the Member for Salford and Eccles (Rebecca Long Bailey), who I think mistakenly used the word “vegetable” when she meant to say “vegetative state.” Actually, I would like to get rid of the concept of vegetative state. It just sounds wrong. To any ordinary person, it sounds like vegetable, but these are people with all their humanity still in there, even if their personality may have changed in all sorts of ways because of the damage. The Minister will not do this, but I beg the medical establishment to come up with another term that is more sympathetic and genuinely expresses not just the downside of the condition, but hopefulness about the possibilities that may still be to come.

As I said, brain damage is not a pandemic and it is not catching, but it is in a lot of people’s brains. The damage has been done, and many people who have suffered that brain damage do not know that the reason why they find it terribly difficult to concentrate or to get up in the morning—they suffer from phenomenal fatigue that hits them like a sledgehammer—why they find it difficult not to lose their temper, or why they get frightened of loud noise or chaotic circumstances and so on is because they had a brain injury at some point. That is all out there and it affects so many Departments of Government. We have had many wonderful warm words from lots of Ministers—this is my fifth or sixth debate on the subject—but now I really do want the Cabinet Office or Downing Street to set up a cross-departmental body to look at the issue in the round, rather than in each of the different silos. I am serious about this, and I am not asking for lots of money. I hope that the Minister will take that back to the Cabinet Office and Government. At some point, I would like the Prime Minister to chair that body, because we could bring about real, positive societal changes if we get this right.

I will set out what specific Departments can do. In the Ministry of Justice, we should be screening all new prisoners coming in so that we can give them proper rehabilitation. We know there will be many people who have not had their needs met heretofore. That will make it easier to run prisons and much easier to rehabilitate those people not just physically, but back into society to lead fruitful lives. The Justice Committee produced a report in 2016 on youngsters in the criminal justice system, which made specific reference to brain injury. I really hope that all the recommendations in that report will be taken up by the MOJ.

I turn to the Department for Work and Pensions. All MPs have experience of the assessment process not being able to comprehend varying conditions. That is one of the problems with many brain injuries: someone might be all right today and, probably because of their brain injury, they want to please the person sitting in front of them, assessing them. They say, “Yes, I’m fine. I am absolutely fine. Honestly, I am fine,” but tomorrow they will not be able to get out of bed, not out of laziness, but because of completely debilitating fatigue. All assessors for personal independence payment, disability living allowance, universal credit DLA, universal credit, and employment and support allowance—everyone—must have a full understanding of brain injury and the way it works.

In the NHS, I know there are shortages in many categories of personnel. If I have one hope for something that might come out of a Government who have a significant majority, it is for more long-term personnel planning. Specific work needs to be done, because we are falling a long way short in the number of beds needed for neurorehabilitation and, in particular, in being able to take children out of hospital and into community services. I have already referred to the rehab prescription.

There are two other bodies that I want to thank as I end. The first is the United Kingdom Acquired Brain Injury Forum, run by Chloe Hayward. The all-party parliamentary group has worked extremely closely with it, and later this year we intend to do more roundtables to gather more evidence to take this work forward. I have discovered there are many spheres in medicine where all the organisations do not speak to one another or sit round the same table. I have been doing work on melanoma, and I would love to bring all the many melanoma charities together so that we have a co-ordinated approach. UKABIF provides that co-ordinated approach, I really want the Government to adopt that model. We could really crack something here if we manage to work on it not just with one Department at a time but with all of them co-ordinated together.

Finally, I am sure my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) will refer to this in a moment, but I want to thank Headway. I had an amazing day speaking to the Headway conference last year. I have referred to some of the professionals, but the most amazing people are probably those who have been through a version of hell that none of us would ever want to experience, having sometimes lost significant members of their family as well. I remember one woman said to me, “I know I have to use all the energy in my head to make my head better, but I am using all the energy in my head to try to work out this DWP form.” That is not what the state should be doing. That is when we really do want a nanny-state to help, to sustain and to support. All too often, of course, it is charities that provide exactly that, and I pay an enormous tribute to Headway for the work it has done.

Health

Alex Sobel Excerpts

Tuesday 14th May 2019 Commons Chamber

[Jonathan Ashworth]

Absolutely. I hazard a guess that when the Secretary of State stands up, he will talk about the support for social prescribing that he has given to general practice so that GPs can send people for more of this activity. But, at the same time, public health budgets are cutting these very types of activities. One hand does not know what the other hand is doing.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

I met Professor Paul Gately of Leeds Beckett University, who set up the applied obesity research centre. He also established Europe’s longest-running weight loss camp for young people, although only the better-off families can now afford it. He asked me to ask my hon. Friend and the Secretary of State why the sugar tax cannot be used to fund some of that work.

[Jonathan Ashworth]

That is an entirely sensible proposal, and I look forward to the Secretary of State’s thoughts on it. The sugar tax is supposed to be funding more physical activities for young people across the country.

At a time of rising demand, we have also seen £55 million cut from sexual health services. That has meant that half of councils have reduced the number of sites commissioning contraceptive services, with the result that 6 million women of reproductive age live in an area where one or more services have been closed. Prescriptions of long-acting reversible contraceptives—the most effective form of contraception—have decreased by 8% at the same time as abortion rates for women over 30 have been steadily increasing. We have seen an increase in sexually transmitted infections such as syphilis and gonorrhoea while, because of cuts, the number of sexual health checks has dropped by 245,000. I was particularly shocked to hear the evidence given recently at the Health and Social Care Committee by Dr Olwen Williams from the British Association for Sexual Health and HIV, who said:

“We are seeing neonatal syphilis for the first time in decades and neonatal deaths due to syphilis in the UK…We are seeing an increase in women who are presenting with infectious syphilis in pregnancy, and that has dire outcomes.”

That was the evidence presented to the Committee about the impact of these cuts on sexual health services in communities.

What about the cuts to health visitor numbers? Last week, we heard concerns across the House about falling vaccination rates, which fell for the fourth time in a row. Vaccinations are one of the most important public health interventions we can make, and our health visitor workforce is vital to ensuring their take-up. Yet public health cuts and wider local authority cuts have meant that we have lost 25% of our health visitors. Every 12 hours since October 2015, we have lost one health visitor, and there are no proposals to reverse those cuts in the long-term plan. School nurse numbers have gone down, and the case loads of health visitors and school nurses are increasing. As a consequence, parents and small children are missing out. According to the Government’s own figures, 14.5% of children are not receiving a six to eight-week review on time, and 24% are not receiving a 12-month review on time. With high caseloads, there are increased risks of abuse or poor health of babies not being picked up, of maternal mental health issues not being picked up and of domestic violence and trauma not being picked up.





We need investment in the wider public health workforce and we need to expand training opportunities. The Government should honour their commitment to pay the public health workforce properly, and especially those on “Agenda for Change” terms and conditions. Last year, when the Government announced a pay increase for staff, they said they would honour that for all public health staff working for local authorities or in the voluntary sector. We are now told that the Government and the NHS are refusing to honour a pay rise this year. I hope the Secretary of State will tell us whether all public health staff employed on “Agenda for Change” terms and conditions will get a pay rise this year.

We are pleased that the Secretary of State has joined us today from the leadership campaign trail. We look forward to his response but, whenever he is asked about public health cuts, he says, “Well, prevention is better than cure.” Who would disagree with that? He never tells us that he is going to stand up to the Chancellor and demand that these cuts be reversed. He simply says that individuals’ attitudes have to change. But it is not just about individuals; it is about the services that are available in local communities. He gives the impression that he just wants people to look after themselves. For example, he said that those who present at hospital with ailments related to alcohol abuse will be targeted for a “stern talking to”—that is his answer. He needs to take it up with The Sunday Times if that was not what he said.

We know that the Secretary of State loves an app, and one of his solutions is more targeted advertising on Facebook. Whenever there is a problem in the NHS, he says that we are going to have more apps; that is the solution to everything. I am told that he and his old friend George Osborne are now part of a WhatsApp group called “Make Matt Hancock Great Again”—there are some problems that even an app cannot fix.

This is not leadership. Real leadership would be reversing the cuts to public health services and intervening to stop the health inequalities and the rolling back of life expectancy advances. Only Labour is offering that leadership on health inequalities. We will fully fund public health services. We will not cut public health services. We will adopt a health in all policies approach; this Government will not. We will invest in the health and wellbeing of every child and meet our ambition to have the healthiest children in the world. Longer, healthier, happier lives will be our mission. I commend our motion to the House.

Mental Health Services: Leeds

Alex Sobel Excerpts

Tuesday 23rd April 2019 Westminster Hall

[Fabian Hamilton]

I thank my hon. Friend for her intervention. York is a city that I know well, and of course York and Leeds are united together through the partnership trust. I will now go on to detail my own experience with the Leeds and York Partnership NHS Foundation Trust, because my experience is similar to the experience that many of her constituents have discussed. The points she makes are very valid and I would be very interested to hear what the Minister has to say in response, not only to her intervention but to what I am about to say.

The reply to my letter to Dr Sara Munro, the chief executive of the Leeds and York Partnership NHS Foundation Trust, was dated 1 March, and it was written by Samantha Marshall of the complaints team, who said she was

“sorry that you have reason to make a complaint and, as a trust, we have failed to meet your expectations.”

Bear in mind that I had written on behalf of my constituent and that I had raised other issues. Ms Marshall went on to say that the trust has had no contact with Mr Downey since he was referred to the IAPT, which is provided by Leeds Community Healthcare, and that she would forward my letter to LCH if I wished. However, no reference was made to any of the other more general questions that I had asked Dr Munro, questions that I believe are highly pertinent to the treatment that my constituent received, and to the treatment that many of my fellow Leeds MPs’ constituents have received as a result of the severe underfunding of mental health services in our area.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My hon. Friend from Leeds North East is making an excellent speech. I had a similar case with one of my constituents, who visited her GP on 31 December 2018 to say that she felt suicidal. She was asked to go home and told that the crisis team would contact her. The crisis team did not contact her. Four hours later, she returned to her GP and then had to go by ambulance to Jimmy’s—St. James's University Hospital. She waited in accident and emergency for 20 hours. Eventually, the acute liaison team gave her a leaflet. That was the level of intervention that she experienced. It was not until my office intervened with the IAPT that she got a referral, and by then she had already made another suicide attempt. That is how the services in Leeds were delivered in the case of my constituent.

[Fabian Hamilton]

I thank my hon. Friend, whose constituency is next door to mine. As I suspected when I requested this debate, there are cases all over the city of Leeds—probably all over the country, but certainly in the Leeds and York area —that highlight the inadequacy of mental health services and the maze that people have to navigate if they need them. That is a source of huge concern.

Safeguarding Vulnerable Adults: Care Homes

Alex Sobel Excerpts

Tuesday 26th February 2019 Commons Chamber

[Dr Allin-Khan]

I thank the hon. Lady—I will call her my hon. Friend—who is tireless in fighting against loneliness and for people to have dignity in their communities, and she makes the most essential of points: we are at the start of a ticking timebomb.

While all this was going on, my father was admitted to hospital one afternoon for a routine issue. As we were undressing him, we found bruises all over his body. Did the Ensham House care staff phone to check on him? No. Did Optivo show any care? No. Instead, we were served an eviction notice, detailing a list of allegations against my father without any evidence. How heartless is it to receive an eviction notice while in hospital? What did Wandsworth Council do at this time? Nothing. What was London Care doing? In the space of just five months, London Care had five separate managers at Ensham House. This all started after the first incident with my father. One manager after another came and went, unfamiliar with my father’s safeguarding cases. Some were hostile, others made up incidents involving my father being difficult. Dementia is a degenerative illness, but it does not spiral downwards overnight. Prior to those incidents, as I previously mentioned, not a single issue regarding my father’s difficult behaviour had ever been reported.

In all meetings, it was agreed that the extra care setting was appropriate for my father as he still knew his way around the area, he had a level of independence and my very young daughters felt comfortable visiting him there. Why deny someone their last few months of independence? The extra care setting was deemed by the social services team and everyone involved to be entirely appropriate for him. However, each time we interacted with Ensham House care staff following the first incident in which we found my father beaten, and when we had not been called, we felt as though we were on trial, that we had somehow made up the fact that he was acting afraid, and our concerns were dismissed by a different manager every month.

We found multiple examples of my father’s medication not being written on the drug chart, with London Care saying that he had refused medication when we had seen him take it. We even found one manager had written a note in the staff communication book asking staff to write negative comments about my father in his care notes. The final nail in the coffin, and the point of no return, was when we found my father unconscious on the floor, with blood on the walls and the floor, and a carer’s set of keys left next to him. Following this, he spent one month in hospital.

Four months after that final event in October, there was nothing from Wandsworth Council addressing any of these concerns. The catalogue of disasters crescendoed last week, when the director of adult social services at Wandsworth Council, Liz Bruce—who had refused to look at photos of my father’s injuries, did not know how many open safeguarding complaints there were relating to my father, did not talk to anyone else who knew my dad and had never met him herself—declared that my father had sustained the injuries because “he had asked for it.” Despite police voicing their concerns in the meeting and saying that they cannot rule out abuse, despite her failure to investigate London Care fully and despite her clearly having no detailed knowledge of the case, she chose to use Optivo’s letter, which was full of unsubstantiated claims in the language of the Ensham House managers, as her proof. Well, I think we can all agree that this is a dangerous, highly unprofessional and highly unsatisfactory approach.

Of course it is easier to blame the patient and the family, anything other than looking inwards and accepting responsibility for the fact that the council is awarding care contracts to organisations that are, frankly, unsafe. Quoting CQC ratings in safeguarding communications, when it is well known that patients are fearful to talk, is frankly unacceptable. If this were happening to the UK’s children, the country would be in uproar, and rightly so. Someone living with dementia is just as dependent in their final years as children are in their first years.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

Will my hon. Friend give way?

[Dr Allin-Khan]

I am just finishing.

With an ageing population and an increase in degenerative illnesses, this issue will only get worse. As parliamentarians, we must act now to ensure that even more families do not experience the horror of finding their loved one bruised, bleeding and terrified. We owe it to the elderly in our community. We owe it to the vulnerable. We have to be their voice. They should not be deprived of their quality of life. We must give our vulnerable a fair chance at ageing safely and gracefully. Their voices must be heard.

[The Minister for Care (Caroline Dinenage)]

I would like to start by congratulating the hon. Member for Tooting (Dr Allin-Khan) on securing this debate. Her speech this evening has been described as brave, but she took the time out yesterday to talk me through this incredibly distressing case, so she has been brave twice. She deserves all our respect and credit for doing that, because, as has been pointed out by others, she is not just talking about her own individual case, tragic though that is, but by articulating it in such an incredibly courageous way, she is also helping to support others who do not have this opportunity to share their voice and raise their concerns in the same way.

Everyone in this House has the same motivation, which is to ensure that our care services for the most vulnerable people are safe and of the highest quality. The hon. Lady talks powerfully about dementia, which is a priority for me personally. I have experienced what it is like to have a close family member, my grandmother, living with dementia. So many people up and down the country share that experience, and I think we all recognise that a dementia diagnosis is one for not only the individual concerned but their whole family. That is why I am so passionate about the need to ensure that those affected by this condition and others are cared for in the best possible way and that a robust complaints process for redress is in place if their care falls short of that.

It would be bad enough if the terrible situation that the hon. Lady describes were taking place in care homes—that would be disgusting and terrible—but she is talking about an extra care facility. Such a facility is where people have their own self-contained homes; they have their own front doors and their own legal right to occupy. So this is a failure of care in someone’s own home—it is a domiciliary care situation. That is why I am even more concerned about what can happen behind closed doors in an individual’s own house. To have a loved one affected by a degenerative illness is terrible for the individual and a matter of huge worry for their family. So I have previously said in this House that every allegation of abuse and neglect should be thoroughly investigated, with prosecutions brought where this is found.

[Alex Sobel]

First, I wish to pay tribute to my hon. Friend the Member for Tooting (Dr Allin-Khan) for her courage and alacrity in her speech. Some constituents came to me about their mother, who had been sexually assaulted in a care home, not by the staff, but by another patient. I was dismayed to hear that unlike nurseries, care homes have no minimum staffing ratio. Will the Minister look into having minimum staffing ratios in care homes, so that these events do not happen?

[Caroline Dinenage]

That is a very interesting question. I have not considered the minimum staffing issue before. We are of course very concerned about training and ensuring that all care staff have a care certificate, so that there is a minimum level of skills training. However, the point about ratios is interesting, and I will take it into consideration.

I do not have a massive amount of time left, so I am not going to discuss in full the details of the individual case raised by the hon. Member for Tooting. However, I must reassure her that what she has raised today is something I take very seriously. My officials have informed me that her raising her concerns so effectively and our inquiries from our office as well have prompted Wandsworth Council to hold another meeting today to discuss her case and review the evidence. As a result, there will be an outcomes meeting—

World Cancer Day

Alex Sobel Excerpts

Wednesday 30th January 2019 Westminster Hall

[John Lamont]

Again, I am grateful to my hon. Friend for raising a powerful case and example. I suppose the question is what would happen were it not for all these volunteers, raising huge amounts of money and raising awareness of cancer, and filling a gap that otherwise the NHS and the state would have to provide for. That is something we should not forget.

That is not to say that we have not made huge progress in tackling cancer. While diagnosis rates have risen significantly in the past decade, the number of people dying from cancer in this country is falling.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

I congratulate the hon. Gentleman on securing this important debate. On the question of diagnosis, I congratulate Leeds Teaching Hospitals and the University of Leeds; their pathology department is the first in the world, I believe, to move away from glass slides to fully digitised diagnosis, and is now working with artificial intelligence, which will improve diagnosis rates and move us forward, so that many more people can get early treatment.

[John Lamont]

The hon. Gentleman makes an excellent point, and raises a very good example. My brother’s father-in-law sadly died a couple of weeks ago. His treatment was provided by Leeds hospital, so I know the tremendous amount of resource and expertise they have in that particular hospital.

For breast cancer in Scotland, the mortality rate was 53 per 100,000 women in 1992. That has fallen to 32 per 100,000, despite the incidence of breast cancer increasing. In short, we are much better than we used to be at both identifying and treating cancer. That is because the UK has taken the steps that World Cancer Day promotes—in particular, tackling tobacco use and obesity levels and rolling out national cancer strategies.

Big issues clearly remain; pretty much all the cancer charities I have spoken to ahead of today’s debate agree with that. We need to get better at early diagnosis, because we know how much of a difference it can make. For example, if bowel cancer is diagnosed early, nine in 10 people will survive, but with a late diagnosis, the survival rate is only one in 10.

Budget Resolutions

Alex Sobel Excerpts

Tuesday 30th October 2018 Commons Chamber

[Alex Sobel (Leeds North West) (Lab/Co-op)]

After the Government have been taken to court and lost three times over air quality, and following the Intergovernmental Panel on Climate Change report stating that we have just 12 years to avert climate change catastrophe, I expected this Budget to deliver the investment we need in clean, green infrastructure for our lungs and our planet. In a quest to bring down costs, the Chancellor has not looked to capitalise on the opportunities that a modern, green economy would bring to the UK. Instead, he has focused on miserly cost-cutting measures. This is a Budget of abject complacency in the face of climate catastrophe. As usual, the Government’s obsession with low-cost public services and their lack of any serious investment have left our environment, the water we drink and the air we breathe off the agenda.

Not only are we on track to miss our air pollution targets, but the Government have lost three court cases and had their policy on air quality ruled unlawful. It has been left to local councils, which have been subject to extreme funding cuts, to deliver change in this area. Where is the commitment to clean air? Air quality affects our health and the health of our children and grandchildren. A recent study linked air pollution to more than 40,000 early deaths in the UK—that is 40,000 people dying before their time because the air they breathe in the fifth richest country in the world fails the required standard.

This is a public health nightmare. The Government have left our national health service strapped for cash as it is. Public Health England has estimated that air pollution costs could rise to £18.6 billion by 2025. If we do nothing and the quality of our air does not improve, there could be 2.5 million new cases of air quality-related illnesses such as lung cancer, asthma and heart disease by 2035. It is not cost-effective to ignore this problem; it is short-sighted austerity politics yet again.

The UK needs to lead the fight for cleaner air and carbon reduction. To do that, we need to incentivise a just transition for health, jobs and the environment. Why, then, has the Chancellor cut subsidies for plug-in hybrid and electric vehicles? How does he expect British drivers to make the switch from petrol and diesel cars if they are not encouraged to do so? Why does a Nissan Leaf have the same VAT rate as a Hummer? Should clean cars not be VAT-exempt? Where is the investment in the electric vehicle infrastructure that we so desperately need? In my constituency there is not a single public charge point; this is fourth time I have raised this issue in the House, and there are still no charge points. There are very few rapid charge points on British motorways, too. That does not build confidence in the new technology, and it leaves EV drivers with charge anxiety. There is no point in encouraging people to buy electric or hybrid vehicles if we do not provide the necessary infrastructure. The Government must do their bit. We need charge points in every community, rapid charge points across our road network and real investment in EV infrastructure and affordability.

Further, we need proper investment in northern heavy rail infrastructure to ensure that people have an alternative to using their cars. Clean rail is lacking in my constituency, where the Harrogate line is still running dirty diesel as the Government first promised then scrapped the electrification programme—a shameful example of this Government’s craven disregard for the north of England.

I recently submitted my consultation response on the plan to scrap feed-in tariffs. This incredibly short-sighted plan will end a scheme that has been successful in encouraging communities, councils and individuals to take ownership of their energy and carbon footprint. While the Government cite increased energy bills to justify their position, they have no plan to replace the scheme with anything other than business as usual for the big six energy companies, which they have conveniently left out of their analysis of consumer energy bills. Where is the investment in proper insulation of UK homes to reduce energy consumption and take so many people out of the fuel poverty they are suffering? All this, and we are still on course to miss our next carbon budget target. When will the Government wake up and realise that we are in the midst of an environmental and public health crisis, and take the necessary action to change course at international, national and community level?

Of course, this debate is about the Budget and health. We have a health service in which our Government’s health economics put the interests of the private sector above those of the public. NHS trusts, including my own, have set up wholly owned subsidiary companies so that private companies can reclaim VAT. In Leeds it is just a service company, but many other trusts have set up wholly owned subsidiary companies that have transferred thousands of NHS staff into the private sector. The solution I had hoped to hear from the Chancellor was that he would put our hard-working public servants on an equal footing and allow the NHS to reclaim VAT in just the same way as those private companies do. But we have a Chancellor who finds a way to put the private sector ahead of our hard-working hospital porters, administrators and cleaners in the national health service.

In short, this Budget has come up short, put the interests of the few ahead of those of the many and put the planet on notice from which it might never recover.