Ambulance Services and National Heatwave Emergency

Diana Johnson Excerpts

Wednesday 13th July 2022 Commons Chamber

[Maria Caulfield]

I am not sure whether that means the hon. Gentleman is now supportive of the social care levy, which is there to pay for improvements to social care. This Government are making those changes and bringing forward the integrated care boards that are bringing health and social care together to deliver on those delayed discharges. I have been very honest: delayed discharges are having an impact on bed capacity and a knock-on effect on our ambulance services. If the hon. Gentleman has changed his mind and now supports the social care levy, I welcome that news.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

With the greatest of respect to the Minister, I cannot fathom why the Secretary of State for Health and Social Care is not at the Dispatch Box when we are facing such a perfect storm. Given that the Home Secretary failed to turn up to the Select Committee on Home Affairs this morning, may I ask the Minister whether this is the Government’s new approach: that members of the Cabinet no longer turn up to be accountable and so that scrutiny can happen in this House?

[Maria Caulfield]

I can reassure the right hon. Lady that I am the Minister responsible for ambulances, which is why I am standing here at the Dispatch Box. The Secretary of State has been out on visits this morning, meeting clinical teams; it is important that he hears at first hand from those who are on the frontline. I got into politics to make sure that those of us who work on the frontline—[Interruption.] The right hon. Lady rolls her eyes; maybe she does not have much respect for those of us who worked on the frontline. We are dealing with this situation, and will be supporting the ambulance service over the coming months. The right hon. Lady’s response is extremely disappointing.

Health and Care Bill

Diana Johnson Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Jess Phillips]

I absolutely agree. It is difficult to be dispassionate. I have never been accused of being dispassionate about anything. I am passionate about what I eat for my breakfast. I am just not a dispassionate sort, but the right hon. Lady is absolutely right that we must look at column A and column B in this instance. Column A is full of experts—medical experts, women’s rights experts, and women themselves—and a huge amount of evidence.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I just wanted to add to the list that the right hon. Member for Basingstoke (Mrs Miller) just read out the World Health Organisation, which also says that telemedicine is safe, and the National Institute for Health and Care Excellence, based in the United Kingdom, which made a recommendation in 2019 about the safety of telemedicine for abortion.

[Jess Phillips]

I totally agree with my right hon. Friend. Actually, if people are against telemedicine for abortion, they might have very strongly held views about not liking telemedicine for anything. By that virtue, they should be against it for everything. For all the people who are desperately worried about vulnerable women—victims of domestic abuse and victims of sexual violence—not being able to access healthcare, I say come on and join me. They are absolutely right: there is zero availability of most mental health support. There is zero chance of getting a GP appointment any time soon, but somehow, people are against telemedicine only on this issue.

Often in debates, we do not stand up to seek to convince others. That only happens when there is a free vote—when actually the debate is really important. To people who are unsure, I say that I understand it—I totally get it—especially if they do not necessarily have so much skin in the game have but a huge load of emails in their inbox. The reality is that if they are not sure, they should either try to be convinced by the debate and the evidence, or they should simply abstain on the issue.

This is not particularly difficult for me. As I have said, I am not a dispassionate sort. I have stood in this House before and said that I have had an abortion. I do not feel devastated by that fact. I think we need to be clear about this. In this place, we only deal in hard cases, because they tell the argument much better. One thing I would say about when I had an abortion is that the worst process of having an abortion is the waiting. I had made the decision about what I was going to do with my body. I had made it the second that I saw I was pregnant on a pregnancy test, because I am an adult woman, completely capable of handling my own body and knowing my own mind, and that is how we should treat every woman in this country.

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[Dr Johnson]

I can only absolutely agree with my hon. Friend’s intervention.

I also want to talk about coercion, because we know that some women may be coerced into having an abortion.

[Dame Diana Johnson]

Before the hon. Lady moves on, I want to raise something with her. Obviously she has a clinical background, and she will know jolly well about the range of safeguarding measures that all clinicians, the royal colleges and all those involved in abortion care have to follow. She makes it sound as though no safeguards are in place. For instance, if a 14-year-old telephoned a clinician to seek advice around abortion, that clinician may well say, “I want to see you face to face.” There is nothing to stop that happening, and that may well be a proper safeguard that would carry on, irrespective of whether telemedicine carries on today.

[Dr Johnson]

With respect, the right hon. Lady makes my point for me, because that is right: there is nothing to stop that happening, and it may be that the doctor would say that they wanted to see the patient, but they do not have to do so. We know that abortions are being prescribed by telemedicine to children under the age of 18. If this measure had been looked at properly by the House as a single issue, rather than as this amendment to something else, we would have stipulated that children under the age of 18 should not be receiving abortions over the telephone without proper appointments, as I think they should and as the right hon. Lady, if I understand her correctly, also seems to be saying that they should.

We know that sometimes women and girls can be coerced into having abortions that they do not want, perhaps because the baby is of a gender or sex that the father does not want, perhaps because they are being abused, or perhaps they are being trafficked or sexually assaulted. It is very difficult for a woman to tell someone about that over the telephone, whereas if a woman is seen in clinic, she has that one-to-one opportunity.

--- Later in debate ---

I am concerned that, having brought in temporary measures, we should have the space to consider and debate this properly, and I do wonder how much of what has been said is ideology and how much is critical appraisal of the evidence. I have to say that I am unclear about whether we really have positive data to support saying that telemedicine abortions are safe. Is it not more a case of the absence of negative data? So what sort of things do we need to look at to understand this better? I would really welcome the Government bringing forward substantive legislation so that we can properly consider, debate and investigate this and other areas of abortion legislation in the UK, and following consultation with my constituents on such proposals, I might support them.

[Dame Diana Johnson]

I rise to speak to amendment (a) tabled by the Government in lieu of Baroness Sugg’s amendment—Lords amendment 92—which would continue the telemedicine service for early medical abortion that was introduced during the covid pandemic. First, I pay tribute to the noble Baroness Sugg for her persistence and her work in the other place.

This is about how we best provide essential healthcare to women, and remember that one in three women will have an abortion during their lifetime. It is about making access as straightforward and women-centred as possible. The Secretary of State recently made a pledge in his speech to the Royal College of Physicians when he talked about the need to

“empower patients and fulfil the promise of the technological leaps we’ve seen throughout the pandemic.”

Scrapping telemedicine abortion at this stage goes completely against what the Secretary of State was talking about. This is also about trusting women, as the Chair of the Women and Equalities Committee, the right hon. Member for Romsey and Southampton North (Caroline Nokes), has talked about and as my hon. Friend the Member for Birmingham, Yardley (Jess Phillips) has said today.

Such is the strength of the evidence that the Welsh Government recently announced that they will be making telemedicine for abortion permanently available. This sends a clear message that, while women in Wales can be trusted to use a healthcare service in a way that meets their needs, women in England cannot. Not only will there be unequal abortion access between the devolved nations, but this decision will lead to health inequalities within England for the most vulnerable and marginalised. I struggle to see how the decision to bring this service to an end after August is in line with the Government’s commitment to put women at the centre of their own healthcare, as detailed in the vision for the women’s health strategy.

Telemedicine has already enabled an estimated 150,000 women to access abortion care at home. Its removal means that every woman, regardless of her personal circumstances and health needs, will be forced to attend a clinic. Lords amendment 92 would ensure that women can continue to access a consultation with a clinician by telephone. To make it crystal clear to everybody, very importantly, face-to-face consultations will still be available. We have heard concerns about younger people, and face-to-face consultations will be available—

[Nick Fletcher (Don Valley) (Con)]

Will the right hon. Lady give way?

[Dame Diana Johnson]

I am going to carry on because I know time is short.

Those consultations will be available if the clinician feels that that is appropriate or the woman wants to see somebody face to face. Let us all be clear: this is about choice. The continuation of telemedicine means that a woman would not have to travel long distances to attend a clinic if, for example, she lived in a remote area or had to make arrangements—

[Nick Fletcher]

Will the right hon. Lady give way?

[Dame Diana Johnson]

I am talking about women’s experience, so I will continue, if the hon. Gentleman does not mind.

The woman may have to make arrangements if she has childcare or caring responsibilities, or she may have to take time off work. In the case of a coercive and controlling relationship, she would have to explain where she is going to a perpetrator, such as the Mumsnet user who said she had to visit a hospital to access abortion care and was “terrified” of her abusive ex-partner finding out where she was. She spoke of having to construct “various lies” about where she was that day and why she had to have someone look after her children.

I referred to NICE and the World Health Organisation in an intervention, but we should be aware that since telemedicine was introduced the risk of complications related to abortion has reduced, as women are able to access care much earlier in their pregnancy. I will rehearse the long list of supporters of the measure continuing: The Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the Royal College of General Practitioners, the British Medical Association, the Royal Pharmaceutical Society, the Faculty of Sexual and Reproductive Health, the TUC, Women’s Aid, Rape Crisis, Karma Nirvana, the Terrence Higgins Trust, End Violence Against Women, Mumsnet, and many others. What I find most disappointing is that the Government are going against a wealth of robust and widely accepted peer-reviewed evidence from medical professionals and women’s charities, and appear to give greater weight to anecdote, erroneous opinion and misinformation focused on campaign groups with extreme views who bombarded a consultation. Sadly, that further emphasises that this is not an evidence-based policy decision.

[Caroline Nokes (Romsey and Southampton North) (Con)]

Will the hon. Lady give way?

[Dame Diana Johnson]

I want to address the issue of safeguarding. Let me be clear: creating more barriers to access does not help women; it helps abusers. The End Violence Against Women coalition and other major VAWG organisations reject the claim that telemedical abortions put women at greater risk of coercive abortions. The fact is that coercive pregnancies are far more common than coercive abortions, and since the introduction of telemedical abortions providers have seen a rise—a rise—in safeguarding disclosures, highlighting that the system provides a safe space for women to come forward if they are being coerced. Nurses are highly trained to assess safeguarding issues, and if concerned they will ask the women to come to the clinic for face-to-face assessment.

Finally and crucially, women themselves strongly favour keeping telemedicine for early medical abortion. A clear majority want it to continue.

As a country, we have an opportunity to be seen to be a shining light for women’s reproductive rights around the globe at a time when those rights are being rolled back elsewhere. The weight of the evidence in favour of maintaining this essential women’s healthcare pathway is overwhelming. I ask Members to support the amendment in lieu.

[Mrs Miller]

First, I apologise for being late to the debate, Mr Deputy Speaker. I appreciate your calling me to speak, and I will be brief.

Amendment (a) in lieu of Lords amendment 92 is all about increasing women’s choice, not about taking choice away from anyone. The basis on which the amendment can be judged is the evidence we have gathered, not in a short period of time, but during two years in which 150,000 women have used telemedical abortion care. Judge the amendment against that backdrop; it is done not on a whim or a fancy, but after two years of intensive analysis.

While I might want to agree with those of my right hon. and hon. Friends who are calling for a reasoned debate in the House of Commons on the broader issues of abortion, the truth is that we do not have those debates because the Government talk about changes to abortion provision coming from Back Benchers when that provision is now so out of date in our country that we need the Government to look at it more broadly. I will support the amendment because it is the right thing to do. The amendment is backed by a huge range of organisations and a significant body of evidence, and it requires the Government to look more broadly at abortion—to take this as a responsibility and to stop shoving it back on to the Back Benches.

Continuing telemedical abortions will be supported and regulated in exactly the same way as face-to-face abortion care, and to suggest otherwise is to be factually incorrect. Members really need to think about the evidence showing that online sales of abortion pills from unregulated providers have decreased since telemedical abortion was made legally available. Rather than push people back into an unregulated market, let us keep what we have, which has worked for 150,000 women over the past two years. But please, please, Minister, let us have a reasoned look at abortion more broadly. Stop saying that this is an issue for Back Benchers. It is not.

Oral Answers to Questions

Diana Johnson Excerpts

Tuesday 1st March 2022 Commons Chamber

[Edward Argar]

My hon. Friend is, as ever, persistent and tenacious in his advocacy of Long Crendon’s surgery plans; not only at the Dispatch Box but whenever he runs into me around this place, it is often the first thing on his lips. I will continue to work with him on the surgery bid and I encourage him to continue to work with his local NHS systems.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

Will the Secretary of State meet me as chair of the all-party parliamentary group on sexual and reproductive health in the UK? Can I bring along the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the Royal College of General Practitioners, the Royal Pharmaceutical Society and the Faculty of Sexual and Reproductive Healthcare to explain why the decision to remove telemedicine is wrong for women in this country?

[Sajid Javid]

Yes.

Government Contracts: Randox Laboratories

Diana Johnson Excerpts

Thursday 10th February 2022 Commons Chamber

[Maggie Throup]

Once again, I make no apologies for the Department working to look at every opportunity to make sure that we had the right mechanisms in place to keep our country safe. As I said earlier, Randox was a recognised company in the diagnostic industry. The hon. Gentleman talks about how he perceives the Department working. The fact is that we have released all the documents. As I said earlier, the 11,000 documents were looked at to identify what was relevant. We have been very open in putting that information in the House of Commons Library and responding to the Humble Address.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

The documents seem to show that there was a meeting with the former Member for North Shropshire and the former Secretary of State for Health and Social Care in the Division Lobby. Will the Minister respond to the question asked by my hon. Friend the Member for Oxford East (Anneliese Dodds)? Did that meeting take place?

[Maggie Throup]

The evidence has been put in the Library and the information is there. I want to make it clear that my Department went through as much evidence as it could. As I said earlier, we were at the start of a pandemic; nobody had ever seen anything like it before. I make no apologies for making sure that we had everything in place to keep the country safe.

Covid-19 Update

Diana Johnson Excerpts

Thursday 13th January 2022 Commons Chamber

[Sajid Javid]

I have huge respect for Lord Frost and for my hon. Friend, who has just shared some important points. No one wants to see this country go back into anything resembling a lockdown. As he will have heard earlier, while we have had to put some restrictions—the so-called plan B—in place over the past few weeks, I hope he will agree that, when we reflect on those restrictions and compare them with other countries in Europe, large or small, we are the freest country in Europe. The reason for that is the pharmaceutical defences that I talked about earlier: we are the most boosted large country in Europe, with the most antivirals per head and the most testing. That is what we should focus on for the future as we learn to live with covid.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I want to press the Secretary of State on the morale of our NHS and social care workforce. He will know that, between March 2020 and May 2021, 1,561 NHS and social care staff died from covid while working on the frontline. That is part of the reason I am campaigning for an NHS and social care covenant, just as we have for the armed forces and the police. What does he have to say to those key workers who saw colleagues die while the Prime Minister was at the law-breaking works party on 20 May?

[Sajid Javid]

The right hon. Lady is right to raise the importance of morale in the NHS. I know that, as I do and every Member of this House does, she will know full well the huge debt this country owes to everyone who has worked in the NHS and the care sector, especially over the past two years. She has talked about campaigning for an NHS covenant; I am not sure how much longer she needs to campaign, because I have already announced we are going to have one. I will be happy to work with her on how we could do that, but she can desist from her campaign and put her efforts into working with me to help to introduce one. She will know that as Home Secretary I decided the police should have a covenant, so it is right that we recognise the NHS in that way too. As for the points she made about the Prime Minister, I refer her to the answer I gave a moment ago.

Covid-19 Update

Diana Johnson Excerpts

Wednesday 8th December 2021 Commons Chamber

[Sajid Javid]

We have secured, I believe, some 180,000 doses of new antivirals. There are two main antivirals that are specifically designed to work against covid-19. As I mentioned earlier in my statement, we are starting a national study that will help us to roll these out and make them targeted and effective. For those who are immunosuppressed and have a positive PCR test, we will be able to use them very shortly.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

Many parts of the country have a lot of jobs that are impossible to do from home. I am thinking of factories and manufacturing jobs, many of which are in Hull. Hull also has below average vaccination rates, so will the Secretary of State say what more we can do to support areas such as that, and would not one start be to improve statutory sick pay?

[Sajid Javid]

It is important that sick pay begins from day one, but in terms of supporting areas—whether it be Hull or others—the right hon. Lady is right to point to the importance of the vaccination programme. The measures that we are taking, especially to help with the booster programme, including bringing on board more pharmacies, more hospital hubs and help from the military, will all help to increase access.

--- Later in debate ---

[Sajid Javid]

We recently took measures to increase take-up among that age group by allowing those children, with their parents or guardians, to use the national booking system and the walk-in facilities, and that has certainly helped boost take-up.

[Dame Diana Johnson]

On a point of order, Mr Speaker. In the light of the Health Secretary’s announcement about the guidance that people should work from home wherever possible, are you able to say anything to the House about what will happen to Parliament before we rise on 16 December?

[Mr Mark Harper]

Further to that point of order, Mr Speaker. I think we established when debating these measures before that it was essential for the proper conduct of business and for Ministers to be held to account that we attended Parliament in person to make sure that the right decisions were made for the British people, and I very much hope that will continue.

Covid-19 Update

Diana Johnson Excerpts

Monday 29th November 2021 Commons Chamber

[Sajid Javid]

Yes, I can give my hon. Friend that assurance.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

Will the Secretary of State give us his opinion on whether every Member in the Chamber should be wearing a mask?

[Sajid Javid]

All Members know what the guidance is, and it is a decision for them.

Health and Care Bill

Diana Johnson Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Mel Stride]

I think the heart of the matter is that we have to be clear and wide-eyed about what this change will do. Yes, it is true that it will leave us in a better position than the status quo, but it is not the case that it will leave those who are less well-off in a better position than if new clause 49 were not passed by the House. For those with assets of about £106,000, by my read of this graph, about 59% of their assets would be lost on average under the original proposals. Under the amended proposals, that figure would rise to 70%. When it comes to those who would be better off as a consequence of new clause 49, many are the better off, because they benefit from the changes being made to daily living costs, to which my hon. Friend the Minister referred.

I am out of time, but I believe that these measures should have been better ventilated in this House—certainly in Committee, if not earlier. We would then have had better information and more time in which to make these important judgments.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I want to speak briefly to amendment 15, which focuses on the membership of integrated care partnerships—the bodies that will be responsible for developing plans to address the health and care needs of local populations. The amendment would enable the Secretary of State to make specific provisions ensuring the representation of particular areas of healthcare on ICPs via secondary legislation.

In particular, I am concerned about having a strong voice for women’s health in ICPs. I also mention in passing the need for other groups to be represented, such as carers, in an ICP area. As co-chair of the all-party parliamentary group on sexual and reproductive health, I have seen how the experience of women in relation to their healthcare is often an afterthought in a fragmented health system, as in the case of the vaginal mesh scandal; the recent debate about pain during the insertion of intrauterine devices, a form of contraception; maternity provision; and cuts to contraceptive services.

The amendment would ensure that the issue of representation was considered by the Government. It has strong support from the medical bodies in this area, including the Faculty of Sexual and Reproductive Healthcare and the Royal College of Obstetricians and Gynaecologists, as well as in other areas of healthcare, such as childhood cancer, and, as previously mentioned, carers groups.

It is important to protect the independence of ICPs and ensure that they can set a strategy that effectively meets local needs, but there is also a need to ensure that women’s voices are not left behind in the decision making. Without this amendment, it cannot be assumed that those voices will be heard on all ICPs. I hope that the Government will consider the purpose of the amendment, which is to strengthen the Bill.

[Theresa Villiers (Chipping Barnet) (Con)]

There is much to be positive about in relation to the recent history of the national health service. NHS England research indicates that the outcomes for most major conditions are significantly better than they were 10 years ago, and the NHS is seeing more patients and delivering more tests, treatments and operations than at any time in its 73-year history—millions more than 10 years ago when the Conservatives returned to power.

To reassure those concerned by some of the campaigns around the Bill, I emphasise that this Conservative Government are committed to NHS values. We are delivering the biggest ever cash increase in NHS funding. It is just plain wrong to accuse the Government of trying to privatise the NHS. In fact, it was the last Labour Government who pushed competition and private sector involvement, including many private finance initiative contracts that proved to be unwise and massively expensive. If anything, the Bill takes the NHS in the other direction by reducing the role for competition and increasing the scope for co-operation.

At the Bill’s core are the integrated care systems considered by this group of amendments. Its provisions on ICSs enjoy considerable support from within the NHS and build on the NHS’s own proposals for reform to make it less bureaucratic and more accountable and to enable it to be more integrated with other local service providers, such as councils.

I will not be backing the amendments in this group except those tabled by the Government. I welcome Government amendment 25 for the clarity that it provides to ensure that appointments to ICBs will not in any way jeopardise their independence. By dismantling elements of the complex system for compulsory tendering of services, we will free up time and resources in the NHS and remove barriers to local co-operation so that we can improve patient care.

We all recognise that ever-increasing healthcare needs place great pressure on the NHS, which will rise in years to come as more of us become frail and need extra care. I ask the Minister, in his response, to emphasise how we will train, recruit and retain the professionals we need to deliver NHS services. Record numbers of doctors and nurses are working in our NHS, and I pay tribute to each and every one, but it is crucial to step up the numbers, especially of GPs. GPs in my constituency are overstretched and we need more of them. That needs to be a priority for the Government.

Covid-19 Update

Diana Johnson Excerpts

Monday 15th November 2021 Commons Chamber

[Sajid Javid]

That would be a decision for clinicians.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I refer back to the question posed by the right hon. Member for Forest of Dean (Mr Harper) on the crisis of vacancies in the social care sector, which I think is currently at 100,000. Will the Secretary of State say something practical about how we will make sure that we have staff in the social care sector for the coming winter, as we know about the knock-on effects for the NHS and the real worry for families across the country?

[Sajid Javid]

One practical example is the record funding going into the sector, which I mentioned to my right hon. Friend the Member for Forest of Dean (Mr Harper). Part of that funding is being used for the largest recruitment campaign the sector has ever seen, and it is already showing results.

NHS England Funding: Announcement to Media

Diana Johnson Excerpts

Monday 25th October 2021 Commons Chamber

[Edward Argar]

I entirely appreciate where my right hon. Friend is coming at this from. I hope that, in answering my right hon. Friend the Member for Forest of Dean (Mr Harper), I was clear that we hugely value the amazing work done by all our NHS workforce. This is about providing them with the money and resources they need to do the job, but also stimulating reform and innovation alongside that. The final point made by my right hon. Friend the Member for Epsom and Ewell (Chris Grayling) was about the calls by some for particular policy approaches to this winter by Her Majesty’s Government. He will have heard my response to that on various media outlets on Thursday morning.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

We are all agreed across the Chamber on the importance of the workforce in the NHS and social care. Will the Government consider—alongside a decent pay rise—a covenant to protect and support our NHS and social care staff, akin to the one that they are introducing for the police and the one that we already have for the armed forces?