Healthcare Facilities: Weybridge

Ben Spencer Excerpts

Monday 21st November 2022 Commons Chamber

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

I am very grateful for having secured this debate. May I start by congratulating our England football team on a resounding victory today? I am hoping to have equal success after this Adjournment debate is completed.

In 2017, Weybridge Community Hospital burned down in a raging inferno so intense that local residents sought shelter in St James’s church. Weybridge Community Hospital was a much-loved community hospital that housed the Church Street and Rowan Tree practices, community nursing, physio, imaging and a walk-in centre in which people could be seen on the day. Now, both practices and community nursing operate out of temporary portakabins and buildings on the site. Even before the pandemic they faced challenges, with concerns around their ability to provide the sort of care that they wanted to provide out of the portakabins standing there.

The pandemic crystalised those pressures on the staff. They are a great team, and I thank all those who work there day in, day out for the benefit of local residents. We owe them and local residents more. I have visited the portakabins, and, quite simply, there is not enough space. Staff work out of rooms without any windows. The working environment is a sight to behold. People are crouched behind desks with files above, below and either side of them. They need more space for their working environment. It is not a pleasant environment to work in. The lack of availability of free rooms hampers the amount of clinical activity that they can do. They have difficulty recruiting. Despite that, they are doing their best and, again, I thank the team working there. But five years on, people living and working in Weybridge need permanent healthcare facilities to be rebuilt, not temporary facilities.

I know from speaking to my residents at their doors and in correspondence that this is a major concern in Weybridge. It is not purely about the current provision of care, which remains a challenge. Both Church Street and Rowan Tree practices have much larger numbers of patients per GP than the national average. There are also several housing proposals being mooted for Weybridge. My constituents already struggle to see a GP or healthcare practitioner. They are rightly saying to me that if the planning authority approves the proposals, it will only get worse. We urgently need improvement in our local infrastructure, of which healthcare is a key part.

Where are we now? Since 2017, there has been much consultation but progress has been hampered by repeated delays, the pandemic, the complexity of joint project working and now, of course, the challenges in terms of inflation. Many people loved the walk-in facilities that the community hospital used to have, but there is an understanding that in the post-pandemic world a walk-in centre is not possible. If we distil the essence of what the community hospital offered and meant to people, we get same-day access to care, whether that is advice from a pharmacist, nurse or member of the extended multidisciplinary team, or speaking to or seeing a GP. I am delighted that in response to feedback from me and other key stakeholders, the clinical commissioning group—now the integrated care system—has confirmed that that is what it is going to provide.

There has been much exploration of how the rebuild could be incorporated into wider town centre redevelopment, which would be of huge benefit to Weybridge. Over the past few years, discussions have included the redevelopment of the Weybridge library building, the development of a super-surgery, incentivising active travel and the creation of a broader community hub. Although the benefit to Weybridge of such improvements is irrefutable, my concern throughout has been the need to prioritise the rebuilding of the health facilities that are urgently needed. Although I share the ambition for town centre redevelopment and improvement, I worry that it would delay the provision needed today. I have argued that we need a two-phase approach to the work: first, get the permanent healthcare facilities rebuilt, and then secondly, move on to the more general town centre community rebuild. We should make sure that the rebuilding of the health facilities leaves options open in terms of the town centre redevelopment.

Many people have been involved in the project over the past five years. I give my personal thanks to Councillor Tim Oliver, who is both a county councillor for Weybridge and the leader of Surrey County Council, for his work and leadership in driving this issue forward. He is not only a county councillor but is involved in the ICS. Alongside the NHS team, which I also thank, he has led the work to drive this matter forward. I also thank the WeyBetter Weybridge team, which has been working on this issue and the wider redevelopment project. In particular, I give my thanks to David Arnold, the chair of the Weybridge Society. I am grateful for his discussions and feedback, alongside all the feedback I have received from local community groups. I thank residents for their engagement at community events and for their feedback to me.

Five years after the fire, our GPs, nurses and admin staff are still operating out of portakabins, not permanent healthcare facilities in Weybridge. Residents are waiting for appointments and not getting same-day access. Patients are still travelling to St Peter’s for physio and diagnostics rather than getting it in their community. We are at the point where work on the detailed plans is under way but no agreement has been reached for the sign-off of the funds needed. This is the crux of the issue.

By way of background, I should say that the NHS self-insures, which means that when there is an event such as the destruction of a building, the money comes out of the funds allocated to the whole NHS estate. That makes sense and saves the taxpayer money, but there is a drawback to the approach. If one approaches an insurance company, it pays out, after the usual wranglings. Where the company finds the money is not the problem of the person who has made the claim. There is a contract, liabilities and expectations. Under the self-insurance model, the contractual arrangements we would see in the private sector do not exist, so we are waiting for NHS Property Services to sign on the dotted line. I understand that it has offered only a proportion of the total amount of money needed for the rebuild, not the full cost, with the ICS and county council left to make up the difference. Not only does that put pressure on my local county council to make up the deficit, but it adds further delay and uncertainty. We already know the pressures that health services and local authorities face, with increased demand for health and social care. My residents should not be forced to face cuts in other local services in order to have adequate health services returned to Weybridge. That is the challenge in delivering the money that is needed for the project.

In summary, although local services are doing the best they can, we need this project agreed now, to provide certainty for residents.

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Motion made, and Question proposed, That this House do now adjourn.—(Andrew Stephenson.)

[Dr Spencer]

We need permanent healthcare facilities rebuilt in Weybridge. When the Minister responds, will he therefore address my concerns regarding the self-insurance model, confirm that NHSPS will cover the cost of the rebuild in its entirety, and agree that rebuilding health services in Weybridge is vital and already long overdue? I will continue to work to support local partners to get permanent healthcare facilities rebuilt in Weybridge. I again thank everyone involved in driving this project forward for all our residents.

Urgent and Emergency Care

Ben Spencer Excerpts

Monday 5th September 2022 Commons Chamber

[Steve Barclay]

The hon. Member makes a very fair point. Within the question he raises is the unmet need where an ambulance does not reach a patient in the community, as opposed to the known risk once the patient is within the hospital trust’s purview. On capacity in A&E, as I touched on in my statement, we put in £450 million at the 2020 spending review to upgrade A&E facilities at 120 trusts.

With respect to the hon. Member’s specific point, he may be aware of the letter that the NHS medical director Professor Stephen Powis and the chief nurse Ruth May sent at the time of the heatwave about where risk sits within hospitals. The taskforce has been doing further work on pre-cohorting, post-cohorting and observation bays so that we can better free up that ambulance capacity and get it back on the road.

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

I very much welcome my right hon. Friend’s statement, particularly the focus on retention, training and recruitment. Earlier this year, I met people from the excellent Chertsey Make Ready Centre. They told me about the challenges that they face with staff wellbeing and staff retention, which are compounded by the horrendous abuse that they receive almost daily. Sadly, it is not limited to our paramedic workers: I met staff at the Crouch Oak practice in Addlestone in my constituency recently, and we spoke about some of the vile messages and threats that they have received. Will my right hon. Friend join me in thanking our health and care service workers for their fantastic work and in condemning the vile abuse that, sadly, some of them receive from a bunch of miscreants?

[Steve Barclay]

I am very happy to join my hon. Friend in thanking the staff for their work and in condemning the completely unacceptable violence, intimidation and abuse to which people are subjected. There should be zero tolerance of that from any hospital trust.

Health and Care Bill

Ben Spencer Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Thank you for calling me, Mr Deputy Speaker, to speak in this debate. I am pleased to follow the hon. Members for Sleaford and North Hykeham (Dr Johnson) and for Congleton (Fiona Bruce). I thank them both for the contributions.

It will be no surprise to the House that I am here because I abide by the absolute view that both lives matter—the unborn child and the mother. I know that many people believe that if someone is anti-abortion, they are anti-woman. I am not—I never have been, never will be and it is not the case. I believe in life and helping people. My career and all my life have been based around that, and I will continue as long as God grants me the strength to do so.

The Minister referred in his introduction to the fact that the regional devolved Administrations will make their own decisions. They can make that decision in Scotland and Wales, but we cannot make that decision in Northern Ireland, because the Government made it here. They took that decision away from us, and I am particularly concerned about that.

I have several concerns about the approach adopted during the pandemic in relation to so-called telemedicine to access abortion, which was recognised at the time as short-term. Without a face-to-face appointment, there is no confirmation of how many weeks pregnant a woman is, which makes a difference to the experience of an abortion at home. As reported in the summary of consultation responses, women who had experienced an abortion said that information should be provided on

“how inaccurate dating of pregnancy may mean increased pain and bleeding”.

A woman whose pregnancy is later than 10 weeks could find herself unexpectedly passing a mature baby at home, which could lead to significantly more complications. I understand that those advocating for the Lords amendment argue that complications have decreased since the pandemic, but I question the evidence, given that the Government and the Minister’s Department say that

“data on complications is incomplete”

and they are working on reviewing the system of recording abortion complications.

I am also persuaded by the concerns about the increased possibility of a woman finding herself pressurised at home to have an abortion that she does not want, as other hon. Members have said. There is a well-known link between abortion and domestic violence. Indeed, the BBC published a survey a few weeks ago reporting that 15% of those surveyed said they had felt pressured into ending a pregnancy. How are we protecting those women? How can doctors know that they are really speaking to a woman who is voluntarily calling about an abortion, or even that they are speaking to the right person at the other end of the phone?

There are many differing and strong views on this subject on both sides of the House, but I question whether the women who find themselves coerced into an abortion from their home, or who have found themselves bleeding unexpectedly at home or having an abortion much later in their pregnancy than they expected, would agree that telemedicine abortion is a positive step in women’s health. I doubt that they would.

I have recently been vocal regarding the need for face-to-face GP appointments. I have been inundated by constituents who simply have no confidence that a diagnosis by picture or telephone call is safe. I have constituents whose cancer has been undiagnosed because the GP was unable to see first hand what would have been clear in a face-to-face appointment. I believe that face-to-face appointments should be available.

I find it difficult to understand how pills to end life—to take away life—in a painful manner for the mother can be given without seeing someone to assess what cannot be seen on the phone. The signs and movements that an experienced GP can see that point to a deeper problem cannot be discussed in the two minutes allocated to such phone calls and I am fearful that the duty of care that we are obliged to discharge will continue to be missed. I am diametrically and honestly opposed to this legislation, because as I said at the outset, both lives matter. Lives could have been saved if abortion had not been available on demand.

I will vote against the permanent extension of this ill-advised scheme today and urge hon. Members on both sides of the Chamber to join me. It is a step backwards rather than forwards in providing adequate support and care for women, and it further normalises the practice of abortion as a phone call away rather than as a counselled decision under medical care, which is what it deserves to be. I, my constituents and my party are clear that this is a massive issue. I fully and absolutely oppose the Government in what they are putting forward today, for the safety of both mothers and the babies, because I am about saving lives, not destroying lives.

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

I rise to speak on the subject of the health services safety investigations body and on abortions. I begin by making a couple of declarations: I am a now non-practising doctor, my wife works as a doctor, and I am a member of the Royal College of Physicians and the Royal College of Psychiatrists.

On the HSSIB, I will keep it brief. I hugely thank the Minister for supporting the Lords amendment and ensuring that we have those safe spaces for doctors. That is critical for the body to work and for us to learn from it. Hopefully, we can undo some of the harms of previous atrocities and what has happened to previous doctors, as has been referred to.

On abortion, it is important to say that I wholeheartedly support and believe that women should have access to safe and legal abortion services, but the regulatory framework around them is complex and it is a sensitive area. As is clear from the powerful speeches that I have heard from both sides of the House, it is also sensitive for hon. Members. Many of my constituents—on both sides of the debate—care deeply and correspond regularly with me about it; I care deeply about it too. I have looked after women who are contemplating having an abortion and I have looked after women who have had abortions, so although I have never carried out one myself—I am a mental health doctor—I have seen it from both ends.

Public Health

Ben Spencer Excerpts

Tuesday 14th December 2021 Commons Chamber

[Sajid Javid]

I can give my hon. Friend that confirmation and I am happy to make that really clear. It is vital that there is always an option for a lateral flow test. I would not support a vaccine-only option.

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

In terms of providing proof of a negative lateral flow test, is that possible for someone who does not have access to the internet or a phone? What is the evidentiary requirement?

[Sajid Javid]

Lateral flow tests are available for everyone. The vast majority of people will have access to phones or through other ways. Once people have taken the lateral flow test and registered the result, perhaps with the help of someone in their family or a friend, they can get printed proof of that by using the 119 service. If there are other ways to improve that, of course we will, but we have found that that is available to the vast majority of people, including those who might not be as familiar with technology.

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

I will speak briefly to ensure colleagues can get in on this important debate.

I will go through the four measures and come up with some big questions that I think we need to ask about what we are doing and how things go forward. First, the self-isolation statutory instrument makes quite a lot of sense. I welcome the Government’s bringing in this change and bringing in daily testing.

On the vaccination of health staff, I declare an interest. I used to work as a doctor and my wife currently works as a doctor. I really have no issue with this measure. When I went through medical school, I had to be vaccinated. I would flip the argument on its head. I would be very concerned about a relative of mine going into hospital and being treated by someone who was unvaccinated. I would be very concerned about them getting covid and becoming very poorly. Fundamentally, this is a basic duty of care issue, but I recognise there are different views on that.

I struggle a bit with the mandatory face mask provisions. This, along with the working from home guidance, will cause harms. Given the Secretary of State’s update today on the omicron wave that is coming forward, I wonder what actual impacts it will have and what the harm-benefit ratio looks like, but there we are.

My real issue is with the covid status certificates. There are many reasons to be concerned about covid status certificates, but I will focus on one. As a doctor, I have spent my career looking after people who are marginalised: people with severe mental illness, people with a learning disability and the digitally excluded. Looking at the measures and the explanatory notes, I cannot see how one can show evidence of a negative test without having access to the internet or having a phone—how any validation process can go through. It is clear to me that it will exclude people. I cannot support excluding anyone, but especially those people who are the most marginalised in our society.

My big three questions relate to what comes next. I had a chat with the leaders of the Ashford and St Peter’s Hospitals NHS Foundation Trust in my constituency about what is happening and what their plans are for the next few weeks. They tell me that already, because of the pivot towards vaccination by primary care, they will have to look at shoring up A&E, because there will not be enough GP capacity and people will be going to A&E. That may have a knock-on effect. The hospital will have to cancel elective care so that A&E can be shored up. They do not want to cancel elective care. It is a great hospital trust and its leaders think they can get through and still do some elective measures. One thing they asked me to ask Ministers today is whether they can have flexibility on what they do around elective care to try to keep it going as much as possible.

There will be a cost in terms of missed GP appointments and missed screening. We have already seen what the cost was in the past year in terms of waiting lists and so on. I would like to hear from the Minister what the plan is to recover NHS as usual after we have got through this wave. Trust me, a protected NHS is not an NHS in which GPs abandon routine care to focus on vaccination. A protected NHS is one in which people can get their blood pressure screening or have a conversation about their mood. It is one in which health visitors see young families and have important conversations about whether a woman feels safe with her husband at home.

My second question is: what happens when the next vaccine escape variant comes? We all feel it is inevitable that another one will come after this wave, so what is the plan to prevent our having to repivot like this again? What is the long-term strategy for living with covid?

My third question is more of a plea. The costs of this pandemic have largely fallen on the shoulders of our children. Please, please, please, will the Minister confirm that there are no plans for mandatory restrictions on schools and that we will never again close our schools?

[Several hon. Members rose—]

Health and Social Care

Ben Spencer Excerpts

Friday 3rd December 2021 Commons Chamber

[Edward Argar]

My hon. Friend, along with many right hon. and hon. Members, is doing his bit to push the cause of his local hospital investment bid. As I said to the hon. Member for Weaver Vale (Mike Amesbury), I commend that, but it would be wrong for me to be drawn while the process is still under way.

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

I thank my hon. Friend for his statement on health and social care planning. The worry is, of course, that the omicron variant will put a lot of pressure on that planning. Will he update the House on where the Department has got in crunching the data on how dangerous or not omicron will be?

[Edward Argar]

The latest statistic I have on the number of cases in this country is, I believe, 42. That work is still being done. We have seen various news reports today on things that might be encouraging, but I encourage everyone to wait and see while that analysis is done. It will take two to three weeks for the scientists to do their amazing work in understanding whether this new variant is more infectious and more virulent as well as how it responds to therapeutics and vaccines, and I am afraid that we will have to be patient while they do that work. Hopefully, they will come back with positive news, but it is too early to say.

Public Health

Ben Spencer Excerpts

Tuesday 30th November 2021 Commons Chamber

[Dr Whitford]

I have given way a lot, and lots of other hon. Members are waiting to speak.

As for the Leader of the House’s nonsensical claim that people cannot catch covid from their friends, I have to say that words fail me—and as Members can well believe, that is not a common occurrence. It is clear that the most common spread is within households. If the Leader of the House thinks that husbands, wives and children are not friendly with one another, I really worry about his home circumstances.

It is early days, but we should be following a precautionary approach. As Dr Ryan of the World Health Organisation has always said: go early and go hard. In the last three waves, the Government often delayed making decisions until the problem was proven. I welcome the changes that they are making to try to get ahead of the curve this time, but as well as taking action on masks, they should advise those who can easily work from home to do so. They should promote “hands, face, space” again, to push it to people who may have got a little complacent.

The Government should also look at how to support the installation and improvement of ventilation. Covid is airborne. Hon. Members will remember how smoke used to hang in a pub before the smoking ban. Any Member who has ever worked in pubs, as I did as a student, will know that smoke would still be hanging there the next morning. That is the issue with poorly ventilated spaces, as we have seen from the outbreaks associated with Committee Rooms in the House.

The arrival of such a variant was inevitable. Last spring, we heard warm words about a global response to a global crisis, but while more than 85% of adults in the UK have been double-vaccinated, the figure is less than 4% in low-income countries, including many that have not been able to vaccinate their healthcare workers.

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

Does the evolution of an immune escape variant, which omicron may be, occur because of a vaccinated immune population or because of a naive population?

[Dr Whitford]

I think that its emergence in southern Africa would suggest that it is from a naive population. One of the issues with our complacency here and reliance on vaccination while allowing very high case numbers is that through Darwinism it can pre-select for vaccine-resistant variants and mutations. Those are the ones that will get a grip; the ones that are vaccine-susceptible will not, because we are so vaccinated.

Allowing high spread, which means common mutations, is a problem wherever it happens, but in the naive populations in the global south there is a real danger. They do not have testing, they do not have the materials, they do not have genomics and they do not have vaccines, so the danger is that they will therefore get a variant that builds up and eventually comes to Europe and to the UK. Sending occasional batches that are almost out of date, as was reported recently to us in the all-party parliamentary group on coronavirus, does not allow Governments in the global south to prepare and use vaccines within date.

The UK is still among the countries blocking a TRIPS waiver. We must realise that it is not a matter of just sharing some leftover doses. We need to massively increase global population, which means sharing intellectual property and sharing technological expertise. If anything, this variant should be a reminder that no one is safe until everyone is safe.

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

It is always a pleasure to follow such a powerful speech from my hon. Friend the Member for Wycombe (Mr Baker).

Today’s debate is fundamentally about uncertainty—uncertainty about omicron. It looks spooky, and it seems to be out-performing other variants in Africa. Why? Who knows. We do not know whether it is going to be more harmful or less harmful; we just do not know.

The problem with these restrictions is also uncertainty. Their direct effect is certainly not trivial. They are going to batter the international travel sector, which has already taken an absolute battering over the past two years. They will yet again have a disproportionate impact on children, when we see the collapse of bubbles in schools because of omicron and our children having to wear face masks at disproportionately high rates compared to adults; yet again, children are going to be the most affected. Sadly, that has been the story of the pandemic thus far.

The real harm from these restrictions is the, “Here we go again.” That is how I felt when the 5 pm press conference on a Saturday was announced again. In the click of a finger, I was back to 2020. I think that everyone at home watching was starting to worry and think, “What is going to come next? Here we go—is this the start of the ratchet again, moving monotonously and inexorably towards higher and increasing restrictions?”. My hon. Friend the Member for Winchester (Steve Brine) was exactly right when he said that it is this chilling effect that does, and is doing, the most harm.

Immediately, I started thinking, “Shall we hold off on ordering the booze for my 40th birthday party in a couple of weeks? Shall we just wait and see what happens?”. There are stories of countless events that we already anticipate will be cancelled, thinking, “Let’s hold off on making clear arrangements about seeing our parents at Christmas” and “Let’s just hold off on ordering the goose or the turkey”. All this has a snowballing impact.

I remember, as I think many people do, when it was just three weeks to flatten the curve. Heaven forbid that because of this chilling effect, people at home say to themselves, “You know what, actually? That lump I found? Let’s not bother the GPs. They’re too busy—too much to deal with, with covid.”. That is a serious and severe concern.

There is a final uncertainty that gives me the most trouble: how much we will really know in three weeks’ time. We know that it takes three weeks to get from infection to hospitalisation and three weeks from hospitalisation to get to death. We have only just started finding our domestic omicron cases. Will we really know from our domestic data in three weeks’ time what on earth omicron looks like: what it is doing, how transmissible it is, and the impact it is having on our NHS? Can we really compare international data with ours? We have had a phenomenal vaccine roll-out. We celebrate the impact of our vaccine roll-out and the booster: it is far better than many other nations’. Are we really comparable in those terms, whatever data ends up coming out across the world? I am really uncertain that we will know in three weeks’ time what is going to happen and what our next steps, if anything, should be.

In the face of the uncertainty that all of us are feeling, where can we find confidence? I would argue: here. Here is where the public find confidence, because they see us standing here debating and scrutinising, raising their points and concerns, chewing over in the most minute detail the SIs that are coming forward, and challenging the Minister on why we are doing what we are doing—having a great debate across the House on these issues. They see this and they have confidence that whatever we do in going forward, and whatever impact we are having on people’s day-to-day lives, we have scrutinised it—that we are here representing them and making sure that we make the best possible decisions.

We have some big decisions to take in three weeks and I do worry about what is going to happen then. Will the data from omicron be bad, will it be good, or will it be “not sure”? Parliament must be able to debate this, being recalled if necessary or, better yet, not going into recess until we have the data so that we know what our next steps should or should not be. For me, in terms of ending uncertainty, I would be grateful if the Minister gave certainty that Parliament will have its say whatever happens in two or three weeks’ time in terms of our response to the omicron variant or wider variants that may pop up between now and then.

Covid-19 Update

Ben Spencer Excerpts

Monday 29th November 2021 Commons Chamber

[Sajid Javid]

The Department already had contingency plans in place for countries being rapidly added to the red list. I believe that more than 600 rooms were made available on Sunday morning, and that will rapidly increase during the next few days. I think it has already increased since then. I believe that most of the information is available on the Government website.

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

I thank my right hon. Friend for his statement. Clearly the problem here is uncertainty. I welcome the analysis, along with the three-week review and the ambition to do it sooner, but following on from the question from my hon. Friend the Member for North West Leicestershire (Andrew Bridgen), does he agree that if the review takes place after the House has risen, we should be recalled to debate its findings?

[Sajid Javid]

That is a decision we will have to make closer to the time.

Health and Care Bill

Ben Spencer Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Paul Bristow]

I agree with the hon. Lady that surgeons work incredibly hard. What I am talking about is operating at the top of the licence and for our consultants to be able to do the things that we want them to do. She is absolutely right; they are doing vital work in other areas running clinics and so on, but ultimately what we have is an elective challenge, and we need to ensure that we spend as much time addressing that elective challenge.

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

Does my hon. Friend agree that one of the challenges for primary care is that general practitioners have absorbed a great deal of the role of social advocacy in our society? People are trying to get a face-to-face GP appointment, and it is sometimes being suggested to them that such things as getting a fitness note or a letter to go to a school might be better served by someone else in the wider multi-disciplinary team. People are getting frustrated, because our messaging about how to use the health service and the different range of roles and responsibilities offered is sometimes getting a bit diluted.

[Paul Bristow]

My hon. Friend speaks with much experience and makes a powerful point. I think he would agree that that core admin function is not what he went into medicine to do. He went into medicine to treat patients. I am grateful that the Minister laid out some of the plans that the Government have to deal with this issue. It is right that we should be looking to the long term, and the 15-year framework for future workforce is to be welcomed, but there also needs to be a much more regular reporting mechanism attached to that to ensure that we as Members are informed, but more importantly the NHS is informed, about how that challenge is going. The integration between NHS England and Health Education England—aligning the delivery arm and the workforce capacity arm—is probably also the right thing to do.

I end with this point: the challenges around workforce will be addressed not only by employing and training more NHS staff, although that is crucial—that is why I have some sympathy for amendment 10—but by ensuring that we work more productively by asking clinicians to operate at the top of their licence. It is also about ensuring that the NHS works smarter. We have created organisations such as Getting It Right First Time and NICE and asked them to go away and do the hard work of coming up with the most cost-effective and efficient ways of delivering care. If we ask those organisations to come up with the pathways and the ways of doing these things, surely it is only right that the NHS then adopts them instead of sitting there and saying, “These things will not necessarily work here.” We ask experts to come up with the right way of performing procedures; I suggest we go ahead and adopt them.

Oral Answers to Questions

Ben Spencer Excerpts

Tuesday 23rd November 2021 Commons Chamber

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

19. What assessment he has made of the effectiveness of the roll-out of booster doses of the covid-19 vaccine.

[The Secretary of State for Health and Social Care (Sajid Javid)]

The UK’s covid-19 vaccination programme has been a recognised success story. It is the largest vaccination programme ever undertaken by the NHS. We are working at speed to get people their covid-19 booster vaccines. Our vaccination programme is making great progress, with over 15.3 million people across the UK already having taken their covid-19 booster or third jab.

[Sajid Javid]

I think my hon. Friend might be wearing a booster badge, because I understand that he has taken his own boost this morning. What more encouragement would the people of Milton Keynes want than their very own Member of Parliament getting boosted? I can tell him that the Bedfordshire, Luton and Milton Keynes clinical commissioning group is in regular dialogue with Healthwatch and the local authority to see what more it can do to encourage local people to take up their booster jabs, and the national “Boost your immunity” campaign is helping to encourage more and more people to come forward, not just for their booster jab but for their vital flu jab.

[Dr Ben Spencer]

I thank my right hon. Friend for his answer and for the speed of the booster roll-out. In fact, it is so speedy that the criteria for getting a booster are changing all the time, and many constituents have contacted me confused about exactly what the criteria are. I have spoken to my CCGs to try to get them to improve the public engagement that they are doing, but will my right hon. Friend lay out what the criteria are for getting a booster at the moment, and what support he is giving to CCGs so that they can get the message out to people and get them into walk-in centres or booking their appointment for a booster?

[Sajid Javid]

My hon. Friend will understand that there is often good reason to change the criteria. They might be changed, for example, on the latest advice from the Joint Committee on Vaccination and Immunisation; the Government must of course consider that advice and take it seriously. As was mentioned earlier, we are extending the booster jab to 40 to 49-year-olds. NHS England has issued guidance to CCGs on the covid-19 vaccination programme, which includes guidance on eligibility for booster vaccines and how to manage those appointments. We encourage everyone to visit the NHS website on gov.uk for the very latest information on the programme.

Menopause (Support and Services) Bill

Ben Spencer Excerpts

2nd reading
Friday 29th October 2021 Commons Chamber

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

I join Members from across the House in paying tribute to the hon. Member for Swansea East (Carolyn Harris) for bringing forward this very important debate and for the campaign she has been running.

I have a different experience of the issue. Obviously, I have not been through the menopause, but as a doctor working in mental health I have looked after several women who have come to me where their depression has been misdiagnosed as the menopause. So I have seen the issue the other way around. I completely get the point that has been made across the House by several Members that understanding and recognition in this area by clinicians is something that people have many concerns about and needs to be improved. One thing that I have really taken notice of is the strength of feeling around that and the medical profession needs to think about that. I should make some declarations. I am still a member of the medical profession. I am a member of the Royal College of Physicians and the Royal College of Psychiatrists, but, as I would say if I was a member of the Scientific Advisory Group for Emergencies, I am here speaking in a personal capacity today.

I want to talk about one of the statistics that has been put out, which is that 41% of medical schools do not have formal training on the menopause. I found that astounding—I had formal training on the menopause when I went to medical school—so it is worth unpicking that a little bit. I had a look in the briefing to see where that came from. My reading of it is that it is not that student doctors and GPs are not getting training; they are getting training. They are getting vocational training on placements with senior doctors who are teaching them, but some schools do not have formal modules in terms of didactic sit-down teaching on it. I think we need to be a little careful when we say there is no training on the menopause and to dig in a little bit. The reason that is important—as I say, I totally get the sentiment and agree on the need for improvement and better recognition —is that we need to be careful about issuing diktats for how the profession approaches its training programmes. If we carve off something for one disorder, the question then is, “Well, what about other things?” Eventually, the strength of the argument will start to diminish, because we will have all different campaign groups saying, “This needs to be separately cut out, and this, and this.”

[Carolyn Harris]

Can I just say, 51% of the population is a huge amount of people who are not getting appropriate care.

[Dr Spencer]

I thank the hon. Member for her intervention and for pointing that out, but I would argue that it is maybe not 51% of the population who are in that situation of needing that care and support. Although 51% will go through the menopause, that is different from saying that 51% of the population will therefore need medical intervention and medical discussions around this.

But like I say, I do not particularly want to get into a deep debate on this; I just wonder whether we could ask the profession what it thinks it can do better, rather than us telling it, top-down. Of course, I would say that, I am a doctor—yadda, yadda, yadda; declarations, etc.—but I just wonder what the profession would say in response to the hon. Member’s campaign about how it can improve things and whether we can hear a bit more about that.

My final point is that, in a sense, I find the fact that we are having to have today’s debate deeply depressing. It is a wider indictment of the problems we have in society with the role and position of women. We have got the Equality Act 2010 and lots of legislation and statute, but as we have heard, when it comes to cultures and attitudes, it is just not there. There really needs to be a step change, given the events of the past year and what we have seen with sexual harassment. I have loads of constituents who come to me and tell me about the disrespect experienced by women. I hear the points made by my hon. Friend the Member for Thurrock (Jackie Doyle-Price). It is frankly appalling that women’s health has been left behind. We need to think carefully about what we can do as leaders of our communities and society to change things and increase respect for girls and women and the position of women in society. On that note, I absolutely pay tribute to the hon. Member for Swansea East for bringing this debate forward and the campaign she is running.

--- Later in debate ---

[Mrs Flick Drummond (Meon Valley) (Con)]

May I also add my thanks to the hon. Member for Swansea East (Carolyn Harris) for this amazing debate and Bill?

When I was first in Parliament, I encountered the exact experiences in all the comments read out by the hon. Member for Luton South (Rachel Hopkins). I was incredibly worried about it. I am delighted that so many people are now speaking out about it in public, because none of that was happening when I was first in Parliament and going through the menopause myself. Other than knowing that hot flushes were part of the process, I had no idea about any of the other symptoms until I listened to “Woman’s Hour” in, I think, 2017 and literally everything became clear: the brain fog, the insomnia, which I am afraid has not gone away—it was in the middle of the night that I heard the programme—and the anxiety and weepiness and feeling that you couldn’t cope with what was happening to you. That was very much part of it. Weight gain is common in Westminster anyway, and a lot of men also gain the Westminster stone, so I cannot blame the menopause for that, but it is certainly something that we need to work on.

That is why this conversation is so important. There are 5.1 million women aged between 45 and 55, and it is estimated that 1.5 million will be going through the menopause at any one time, yet we are so embarrassed to talk about it. Husbands and partners are at a loss as to why their wives and partners are struggling, because the symptoms have been hidden from public knowledge. If I had known some of the symptoms before, I could have dealt with them better, and I am sure my husband could have as well. That “Woman’s Hour” programme was a saviour for me, because suddenly I understood what was happening, and if you understand what is happening, you are better able to face it.

Turning to HRT, I never take medication, apart from the odd pain killer, so taking something to control a natural process was something that I did not consider—probably mostly from ignorance, I should add—but I completely understand that others need medical help. The House of Commons Library briefing states that

“16,000 women were admitted to hospital in England in 2019/20 with conditions associated with the menopause.”

I had absolutely no idea, and I am sure that most of the public do not either.

The case on HRT has been well made, so I will not say more on that, but I do hope that we can consider how it can be made affordable, because, otherwise, it will become a postcode lottery. I am very grateful that a Member who represents a constituency in Wales is interested in looking after all of us who live in England.

I wish to comment on the second part of the Bill, because it is very important. I am really pleased that everything has been raised so publicly, but it is extraordinary that it is only in the past four years that people have been bold enough to speak out, when this has been happening to millions of women for centuries. The big change is that more women are in the workplace now than at any time over the past 100 years, and nearly half of all women are over 50. I am really pleased that we have the menopause workplace pledge, with so many employers leading the way. I hope that Parliament has signed up to it, too. Flexible working hours are essential, especially as lack of sleep is a big issue. Another thought is allowing women to come later into work if they travel on public transport, so that they do not have to crowd themselves in when they are feeling incredibly hot. I have come off the tube so many times absolutely drenched in sweat and incredibly embarrassed that I do not have a change of clothes when I get to my office.

The point about training GPs is crucial, too. I listened to what my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) had to say. I spoke to a doctor about this and found that the issue is barely covered in their initial medical training. For GPs, the clue is in the name—the name is general practice, which means that GPs have to cover a huge area in their curriculum, and it is not mandatory to have additional training for a condition such as the menopause in their professional development. I would very much like to see such training being seen as part of their professional development and it should be taken perhaps every year or every few years, so that they can keep up to date with every aspect, whether it be HRT or anything else on the menopause.

[Dr Spencer]

Does my hon. Friend hope that the chair of the Royal College of General Practitioners is listening to this debate today and responds to the hon. Member for Swansea East (Carolyn Harris) on what we are talking about on GP training?

[Mrs Drummond]

Absolutely, because it is incredibly important that people understand what we are going through—whether we are talking about men or women or people of any age. As someone who does not see the same doctor twice in their practice, although I have not been there very often, I do not have that relationship with a GP, so I would feel embarrassed about going to ask for something that I did not know much about.

On the peer-to-peer point, when I returned to Parliament in 2019, I looked around at the new intake and started approaching women of a certain age—I call them my WOCA group—to form a support group to help those going through the menopause. This has been a lifeline to us, and I hope that everyone else considers that as well. [Interruption.] I can see Madam Deputy Speaker indicating to me.

Finally, may I thank the hon. Member for Swansea East. She truly is a force of nature and I congratulate her on all the things that she is achieving in Parliament, and it is such a joy to work with someone on the Opposition Benches to make a real difference to people’s lives.