Prisons

Debate between Dan Poulter and Maria Caulfield

Wednesday 25th January 2017 Commons Chamber

[Maria Caulfield (Lewes) (Con)]

I start by paying tribute to all prison officers in this country, who do a fantastic, difficult and often dangerous job, and particularly to those at HMP Lewes in my constituency, which has seen disturbances in recent months and was put into special measures just before Christmas. I am not sure whether the shadow Minister has visited Lewes prison—I know that the prisons Minister has—but I encourage him to do so if he has not. Having visited the prison on a number of occasions, I know that one cannot fail to be moved by the dedication of the prison officers who work there so tirelessly.

I am disappointed by the Opposition’s motion—I note that no more Opposition Members wish to speak—because it fails to demonstrate any understanding of the issues facing prison officers day in, day out. This is not just about staffing levels. In Lewes prison, for example, there have been a number of vacancies for some time, but the prison has not been able to fill them. I take on board the point made by my hon. Friend the Member for North Dorset (Simon Hoare) because it is hard to fill such vacancies in a rural constituency in the south-east of England. I welcome the Secretary of State’s moves towards local recruitment, whereby a governor can manage people leaving and have replacements ready at hand, as well as managing the skills mix and experience of their prison officers to make the transition much easier.

Lewes prison is difficult to manage because its old buildings make it difficult to see what is going on, particularly with reduced staff numbers. It is also a depressing prison inside—there is hardly any lighting—which makes it a tough place not only for inmates, but for the prison officers who work there day in, day out. The inmates are changing. While there are the usual faces who keep coming through the revolving door, there are also now sexual offenders. That type of prisoner was never there 10 or 15 years ago, so that has increased pressure on the prison officers and prisoners.

In the minute and a half remaining, I want to support what my hon. Friend the Member for Salisbury (John Glen) said about the Opposition. Labour Members have not even touched on what motivates people to commit crime, and therefore enter prison, in the first place. We know that a quarter of prisoners have been in care at some point in their lives, that 59% of those entering prison are reoffenders who have been in prison before, and that about three quarters of prisoners have problems reading or writing.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

Will my hon. Friend give way?

[Maria Caulfield]

I will not because there is so little time.

We absolutely have to deal with the way in which people enter prisons. I have talked to young people in Newhaven Foyer in my constituency, many of whom have come from the care sector. Many of them deliberately committed crime to get into prison, because they were not confident about getting housing or care, and many of their friends are in prison already. Until we address issues relating to life chances, the same people will be going through the prison system.

I know that the Ministry of Justice is not working in isolation. It is working with the children’s Minister, with the relevant Health Minister on mental health problems, and with the Housing Minister to deal with housing problems. That is why I am so disappointed with the Opposition motion, which fails to tackle any of the factors that contribute to prisoner numbers and shows no understanding of them at all.

NHS and Social Care Funding

Debate between Dan Poulter and Maria Caulfield

Wednesday 11th January 2017 Commons Chamber

[Maria Caulfield]

These problems are not new. I have also worked in out-patient settings where A&E targets have had an impact on patients waiting for elective surgery. The sheer determination to meet those targets due to pressure from the Labour Government led to patients with breast cancer having their elective operations cancelled time after time owing to emergency admissions. I had to tell a young mum, whose mastectomy operation following breast cancer had been cancelled three times while her young family were waiting for Christmas, that the only bed we had left was in a post-natal ward, where she woke up and recovered from her operation next to young mums learning to breastfeed. That was in an attempt to meet four-hour targets, so do not tell me that services have reduced. Targets were met, but staff were put under severe pressure not with quality of care but with targets in mind. I make no apologies in making that clear.

I am a supporter of four-hour targets. I was enthusiastic when they were introduced as a way of monitoring performance and improving the service, but they became the absolute king, above everything else. I congratulate the Secretary of State on introducing the consideration of outcomes. What happens to a patient when they are admitted? If they have to stay for four and a half hours to avoid admission or to get full care, what is the problem with that? If they can leave within two hours because they have been adequately treated, fantastic, but we should not be held to account by an arbitrary four-hour rule that has no clinical significance. I support the four-hour rule, but there are other measures that we also need to be aware of and that should be treated with equal status to the four-hour target.

Of course money is important. As our ageing population and our ability to treat more patients grows, we will need more funding for both healthcare and social care. It is worth noting that the trusts either side of my constituency receive the same funding and look after the same types and numbers of people. One is in special measures, is unable to deal with its discharges, has queues and is unable to meet its four-hour targets; the other, five miles along the coast, is rated outstanding, does not have the same pressures or four-hour waits and is able to discharge its patients speedily. There is something about what happens to the money, as well as about how much the money amounts to.

Labour did put huge amounts of money into the NHS over the years, but much of it was squandered—£10 billion on a failed IT project that never saw the light of day, and PFI deals that are still costing the NHS £2 billion a year. How much could be done with that £2 billion?

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

Will my hon. Friend give way?

[Maria Caulfield]

I will take one brief intervention.

[Dr Poulter]

I commend my hon. Friend for making a balanced speech and for rightly saying that meeting targets does not necessarily equate to delivering good healthcare, although they do have their place. Does she agree that one of the biggest challenges is the consistent inability of a number of A&Es across the country to recruit middle-grade doctors? That is one of the biggest problems that has not been addressed to date.

[Maria Caulfield]

I absolutely agree that there is a problem in recruiting staff, particularly in the south-east—including in my constituency—in all healthcare professions because it is an expensive place to live. I agree that there is an issue with recruitment, but if we are to move forward, we need to work in a more cross-party way. Continually using four-hour targets as a stick to beat the Government with does nothing for cross-party working, so we need to stop the political cheap shots and recognise that money is not always the solution—it is about how the money is spent and the difference it can make. This also has to be clinically led. We can work together as politicians, but if we do not work with healthcare professionals, in both primary care and secondary care, I fear that we will be sitting here again in the years to come to talk about another winter crisis.