Tackling Obesity

Fleur Anderson Excerpts

Tuesday 27th February 2024 Westminster Hall

[Fleur Anderson (Putney) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I congratulate the right hon. Member for Bexleyheath and Crayford (Sir David Evennett) on securing this important debate. As he said, it affects all MPs because it affects all our constituencies. It affects families across the country.

I am here because I recently visited Putneymead Group Medical Practice in my constituency. It is a really large surgery, which serves 25,500 people and employs 23 GPs. They know what they are talking about; it is an excellent facility. I asked the doctors what the main issues were they were facing, and they said that the main issue was childhood obesity. They were worried that the current state of the NHS meant that it was unable to provide services to combat childhood obesity, and they were also worried about the lack of services for primary school children. Early intervention is very important in tackling childhood obesity, but they were also concerned about secondary education. They mentioned Wandsworth Borough Council provision for primary school children, but that ends at year 6. In secondary school, there is even less provision and support for tackling obesity, and they identified that as a key issue.

Today, two in every five children in England are overweight or obese by the time they finish primary school. That has lasting consequences for their physical and mental health and for their quality of life. The national child measurement programme found that in 2021-22, 10% of reception-age children in England were obese. The proportions were higher among year 6 children, with 23.4% being obese. Something is going wrong in our provision and support programmes for primary school children.

Childhood obesity is a significant concern in my borough of Wandsworth, where more than one fifth of children in reception are overweight or living with obesity. In year 6, that figure rises to 37.7%, which is higher than in the rest of the country. Wandsworth Council has several programmes to tackle the issue. The Health4Life team runs the Mums, Minis and KickStart programmes for primary school-age children and their families. The children’s school food strategy and the campaign targeting takeaways near secondary schools are also having an impact, but that needs to be amplified and supported by having the same programmes across the country. As I said, this support needs to be maintained and to continue through secondary education, as well as through primary. In the United Kingdom, the prevalence of obesity among year 10 children is still 23.4%, so one in four children are still classified as obese—in London, the figure is still 37.4%.

It is essential to continue promoting healthy lifestyles, but there are also significant infrastructure issues. There is an issue around planning and having shops with healthy produce in the right places so that they are easier to access for people who do not have the same transport options as others. We also need to tackle takeaways near secondary schools, which Wandsworth Council is starting to do, and there are elements of good practice that can be learned. In addition, we need to tackle inactivity in schools. Many playing fields have been sold off, which has reduced access to physical education classes in school. I have seen that with my own children, who have gone through secondary school with significantly less access to PE lessons than I had when I was going through school.

There is also the issue of healthy eating and teaching cookery. I pay tribute to a great community organisation in my constituency called Bags of Taste, which teaches people how to eat better for less. It has a really high take-up, and people really enjoy making the kind of food they would get from a takeaway but can cook for less money in their own homes. That is to be applauded and supported.

There could also be much more action taken by supermarkets, and action on advertising unhealthy food. Another excellent programme that I have seen really working, but that is not taken up comprehensively enough, is the Daily Mile. Having started off with a school in Stirling in Scotland, it has been taken up by many primary schools around the country. It is tackling this issue and making a difference.

To conclude, Labour will tackle childhood obesity through a range of measures, including by implementing the 9 pm watershed for junk food advertising, getting kids moving through a mandatory national curriculum with a wider range of physical activities, providing free breakfast clubs in every primary school and taking action to end the promotion of junk foods targeted at children. We will take action. The current obesity figures are a damning indictment of 14 years of Tory rule that have not worked. It is time for Labour.

Building an NHS Fit for the Future

Fleur Anderson Excerpts

Monday 13th November 2023 Commons Chamber

[Helen Whately]

I am not going to stand here and explain whipping policy, which is not my job as a Health Minister, but I am delighted to see the potential of this legislation. As with so many other worthwhile Government policies, such as increasing funding for the national health service, I would be delighted to see the right hon. Gentleman and other Opposition Members support this policy.

We are also cracking down on the alarming rise in vaping among children. There is no doubt that vaping is safer than smoking and is a terrific tool to help adult smokers quit, but, like Members across the House, I am concerned that one in five children has tried vaping, which can be hugely damaging to their health. The whole House knows that no child should be using nicotine.

The rise in youth vaping is no coincidence. Disposable vapes are consistently marketed at children and are available at pocket-money prices, with many retailers ignoring their duty not to sell them to young people. With more than 5 million being thrown away every week, disposable vapes are also damaging our planet. We are acting now to protect our children and our planet. We are looking at banning child-friendly flavours, restricting colourful packaging and mandating that vapes are displayed only behind the counter. We are also exploring a ban or a restriction on disposable vape sales and empowering local authorities to dish out on-the-spot fines for selling vapes to children. All these proposals are being developed with parents and teachers across the UK, and they will strike a balance between giving adult smokers a choice to switch to vaping and preventing our children from taking it up.

I recognise the disappointment that the mental health Bill was not included in the King’s Speech, but I can assure hon. Members that this Government are committed to achieving genuine parity between mental health and physical health, improving the care of those detained under the Mental Health Act 1983 and bringing forward the Bill when parliamentary time allows.

We are not going to wait for legislation to make change. We will continue to pilot models of culturally appropriate advocacy, providing tailored support to hundreds of people from ethnic minorities to better understand their rights if they are detained under the Mental Health Act. This comes on top of the record investment and staff numbers we are putting into mental health. Since 2010, the mental health workforce has grown by more than 20%, and by March we will have invested over £2 billion more in mental health than four years ago, meaning that 2 million more people, including more than 300,000 children and young people, will benefit from mental health support.

[Fleur Anderson (Putney) (Lab)]

One of the biggest issues raised by every school I visit in my constituency is mental health support, and I am disappointed not to see the mental health Bill in the King’s Speech. Will it be addressed in any other way? Where is it?

[Helen Whately]

As I said a moment ago—let me remind the hon. Lady of this—we are not waiting for legislation in order to bring forward mental health reforms. That is why, for instance, we have already been rolling out mental health support teams in schools. We are already ahead of schedule on that; we are giving a quarter of England’s school and college children access to mental health support teams a year ahead of schedule. In addition, thanks to this Government, dormitory accommodation for mental health patients will soon become a thing of the past.

It has been a pleasure to work with the new Secretary of State for Environment, Food and Rural Affairs, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), and a huge honour to work with my hon. Friends the Members for Colchester (Will Quince) and for Harborough (Neil O'Brien) as part of a Government taking the long-term decisions to build a health and care system for the future, one with more doctors, nurses, pharmacists, physios and care workers, better mental healthcare for adults and children, more proactive care in the community, greater capacity, the newest technology and more choice, where conditions are diagnosed quicker or prevented altogether, thus helping people to live longer and healthier lives.

--- Later in debate ---

[Fleur Anderson (Putney) (Lab)]

It is an honour to speak in this historic debate on the first King’s Speech for 72 years, but, to be frank, it is not a pleasure. When I go around and talk to people in Putney, Southfields, Roehampton and Wandsworth town about what I can say for them on their behalf in Parliament, many just shrug their shoulders and say, “Where do you start?”, because there are so many things they feel that the Government should be doing that they are not doing, whether that is: the climate crisis; the cost of living crisis; a million children living in destitution in the UK; the damage to our international reputation; or the NHS crisis, with 125,000 vacancies in our NHS and nearly 8 million people on waiting lists. Those are all things that my constituents think should be tackled by the Government, and I just have not seen that in the King’s Speech. It is disappointing.

Before turning to the pressing issue of healthcare, I put on record my disappointment at the lack of legislation to move us towards a net zero green future in the King’s Speech. There could have been so much more in that legislative programme. It is being left to Labour to pick up the pieces, but we will do so in all our actions for Government. There is also welcome reform for leaseholders, but the legislation is too weak and is mainly not for current leaseholders, but for future and new-build leaseholders. I am pleased to see that the Government have reintroduced the Renters (Reform) Bill in the King’s Speech, but the long delay has caused suffering across the country and across London. Will the section 21 eviction ban actually see the light of day, as we need it to?

I will focus on three serious issues of concern on healthcare for my constituents: the dropping of any reform to the Mental Health Act; dental health; and, support for GP surgeries and primary healthcare.

Last week, the Government broke yet another promise to reform the Mental Health Act—a promise they have been making for six years. There has long been cross-party support for reforming the Act. A Committee met from summer last year to January, and a report was made, but it has not received any Government response. Legislation is there, waiting to be put into place.

The Mental Health Act 1983 is outdated and unfit for purpose, yet it remains the main piece of legislation outlining the rights of people who are being detained in hospital for mental health treatment. There are huge problems with it. Black people are five times more likely to be detained under the Act and more than 11 times more likely to be given a community treatment order than white people.

The Government are letting down people with autism and learning disabilities. In September alone, more than 2,000 autistic people and people with learning disabilities were detained in mental health hospitals in England, including 205 children—often in solitary confinement. The Care Quality Commission has said that these people

“continue to be in hospital inappropriately when they should be receiving care in the community.”

There were concrete plans to tackle that in the draft Mental Health Bill, but that has been dropped. What are the Minister’s plans to take action on this issue going forward? The reforms were a crucial chance to give people more dignity and independence, yet the Act continues to fail children and young people in particular. It takes away agency from those detained to have any say over their treatment.

Mental health is not the only area in which the Government are failing our NHS: my constituents are unable to get GP appointments. The most recent GP appointment survey data found that the proportion of people who secured an appointment when wanted has fallen to just 51%: the lowest level in five years. Too often, our GP surgeries—the premises—are unsuitable, with a report from the Royal College of General Practitioners finding that 40% of GP staff consider their premises unsuitable. I was told in a recent letter from a GP in Putney how far too many surgeries are

“stuck in tiny residential buildings”,

which really affects GPs’ ability to provide the services—prevention services in particular—that they want to provide. Will the Minister tell the House what is being done to improve the GP estate—GP surgeries in particular—and to expand it in future?

Labour would reverse the decline in GPs by doubling the number of medical school places to 15,000 a year, rapidly improve GP appointment performance and provide a public service that has time for people with more complex needs. Labour’s NHS workforce plan will train a new generation of doctors and nurses.

Also missing from the King’s Speech was any mention of dentistry. At my most recent visit to a local GP surgery, I said, “What is the main issue that you face?” I expected all sorts of issues that we might think would be bigger, but they said that it was NHS dentistry for children. They are seeing the impact of that—people cannot get an NHS dentist appointment, so they come to their GP—and that problem is growing, especially for children. It is increasing the health inequalities in my constituency, which I see from one part of the constituency to another in dentistry more than anything else.

During covid, I took part in many debates in which we laid out how the NHS dentistry contract was going to fail local people and how it was not fit for purpose, yet it was not changed then and the problem has been exacerbated since. Labour will address the immediate crisis in NHS dentistry by providing 700,000 more urgent dental appointments and recruiting more dentists. In the long term, it will reform the NHS dentistry contract as well so that everyone who needs an NHS dentist can get one.

Alongside reform of the Mental Health Act, Labour will transform mental health services in Britain so that timely support is available to those who need it. We will recruit thousands more mental health professionals, provide mental health hubs in every community and put mental health support—that crucial early prevention work—into every school.

The Government must now make way for a party with a vision for a revitalised NHS that works for everyone or risk running our healthcare service further into the ground. It is time for a general election now.

Mental Health Treatment and Support

Fleur Anderson Excerpts

Wednesday 7th June 2023 Commons Chamber

[Neil O’Brien]

I will make a bit of progress before I give way.

The long-term plan will ensure that 345,000 more children and young people can get the mental health support they need when they need it.

We are committed to ensuring that children and young people can access mental health support in school, so that they can access help with anxiety and depression and other common mental health services before problems become more serious. In that way, we can prevent—in exactly the way we all agree on—the problems from becoming more serious. That includes continuing to roll out mental health support teams to schools and colleges in England.

[Fleur Anderson (Putney) (Lab)]

The picture that the Minister is painting does not quite tally with the experience that I am seeing in families, many of whom are watching with a feeling of helplessness as their children’s mental health deteriorates while they are on long waiting lists. In the NHS South West London ICB area, there are over 10,000 young people on waiting lists, and many have their cases closed without even getting the support they need. That leaves them with deteriorating mental health and it leaves their families in despair. How is it that the money the Minister is talking about does not seem to get through to the young people who need help?

[Neil O’Brien]

I will come to the point about waiting lists in a moment.

Let me complete my thoughts on prevention, which I think we all agree is important. There are 3.4 million pupils covered by mental health support teams in 2022-23, which equates to about 35% coverage of pupils in schools and learners in further education in England. We expect around 500 teams to be up and running by 2024, covering around 44% of pupils and learners, so it will be up from 35% to 44%. Over 10,000 schools and colleges now have a trained senior mental health lead, including more than six in 10 state-funded secondary schools in England. On prevention, the Government are also providing £150 million of capital investment in NHS mental health urgent and emergency care infrastructure over the next two years.

Draft Mental Health Bill 2022

Fleur Anderson Excerpts

Thursday 26th January 2023 Commons Chamber

[Dr Poulter]

I agree with the Minister. He is right to suggest that this is an important step forward and this piece of legislation will make a significant difference to patients, but it is part of a process, not the end of the journey. In particular, I draw the Government’s attention to the potential unintended consequences of some of the well-meaning changes being proposed in relation to patients with learning disabilities and autism and to changing the grounds for detention; for example, it might be harder to detain patients who are the most unwell, with chronic and enduring mental illness and psychotic conditions. I hope the Government will take on board those concerns and ensure that what comes back to this place is a stronger Bill that works in the best interests of patients.

[Fleur Anderson (Putney) (Lab)]

I welcome this report, and in particular the section on racial inequalities, which have been highlighted in my constituency by organisations such as the Wandsworth Community Empowerment Network for many years. Is the hon. Member optimistic after hearing all the evidence from organisations that the inequalities affecting black and minority ethnic groups, especially in terms of culture and policy, will be improved?

NHS: Long-term Strategy

Fleur Anderson Excerpts

Wednesday 11th January 2023 Commons Chamber

[Fleur Anderson (Putney) (Lab)]

I am worried and angry about the complacency that I have seen from the Secretary of State towards the NHS. Look, I knew that the situation was bad, but I did not realise how bad until I visited St George’s A&E last week. That hospital, which serves my constituency, had to declare a critical incident because of the situation in its A&E. All the doctors and nurses I spoke to agreed that it was the worst time that they had experienced in their whole careers. The winter ward was opened last year but had to stay open for the whole year, so there is no more space for the extra winter surge. Sixty nurses have resigned from that department because of the stress of the workload and being underpaid.

The additional winter payments that came from the Government were paid only in December and must be spent by March, giving them hardly any real impact. The situation is chaotic. The doctors and nurses are having to practise corridor care for patients for the first time in the hospital, and they are broken-hearted that they have to do so. They have had to stop elective heart surgery since the beginning of December. Mental health patients are being treated in A&E for five days. We need a long-term plan, not to be surprised by winter every year.

Four areas are seen as having critical community care shortages: eating disorders; Korsakoff dementia patients; frail patients who have a stroke after a fall; and functional neurological disorder. Those huge gaps in community care were raised by the staff. I am glad that the Secretary of State is in his place to hear me raise them.

The Conservatives are failing the people of Putney, Southfields and Roehampton. The Conservatives are failing the British people. Labour has a plan to fix this, but they do not. Pain, suffering and preventable deaths are up, GP waiting times are up, A&E waiting times are up, and mental health and cancer assessment times are up. There is only one conclusion: the Conservatives’ time is up.

Government PPE Contracts

Fleur Anderson Excerpts

Tuesday 6th December 2022 Commons Chamber

[Fleur Anderson (Putney) (Lab)]

I am delighted to be able to close today’s debate on behalf of His Majesty’s Opposition, and I share the indignation of my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner), the shadow Chancellor of the Duchy of Lancaster, that we are once again having to come here to table a Humble Address to force the Government to come clean with the British public. It is all about transparency, and there are questions that need to be answered. Conservative Members can either support today’s binding vote to force Ministers to come clean, or they can be complicit in the continuing cover-up. The choice is theirs, and their constituents are watching.

The VIP lane is a national scandal that will cast a long shadow for years to come. It takes us back to the dark days of 2020 when covid was spreading, when people were dying and when there was not enough PPE for frontline workers. Schools donated goggles. Volunteers sewed gowns in their homes. Nurses and care home workers had to resort to wearing bin bags. My hon. Friends the Members for Blaenau Gwent (Nick Smith), for Brent Central (Dawn Butler), for Bradford West (Naz Shah), for Nottingham East (Nadia Whittome) and for Llanelli (Dame Nia Griffith) have articulated well the anger that is felt by our constituents across the country, who want to have their questions answered.

The shift to procurement was necessary; no one is denying that. We had to have fast procurement, but that did not need to lead to all procurement procedures being jettisoned along the way, resulting in the failure to provide usable PPE, the granting of huge contracts to shell companies, the industrial-scale waste of taxpayers’ money and then an industrial-scale cover-up. A total of £12.6 billion was spent on PPE, but £8 billion of that was written off. We know that £4 billion-worth of PPE was not up to standard and was unusable, that £3.6 billion-worth of contracts raised one or more red flags for possible corruption, according to Transparency International, and that 176 contracts worth £2.6 billion are now in legal dispute.

The consequences continue, as we have heard from Members today. Up to three weeks ago, £770,000 was being spent every day to store the faulty PPE here and in China. I had to check that several times; it could not be right. Were we really spending £770,000 every day? That was over £5 million a week, or £280 million a year. That is enough to pay for free school meals for all the primary schoolchildren in Manchester, Birmingham, Leeds, Liverpool and Nottingham put together, or to pay 8,000 nurses a year. I have heard the clarification from the Minister that the amount has been reduced, and that is welcome, but we are still spending £400,000 a day and 120 million PPE items are being stored in China. What is going on? I speak today for the millions who are sat in freezing homes relying on food banks during this cost of living crisis and hearing that Britain is being ripped off by the Tories.

The British Medical Association’s chair of council said:

“The deadly mismanagement around the supply of PPE is one of the greatest failings of this Government’s handling of the pandemic”.

There must be a reckoning.

The Government had been in power for a decade when covid began, but they did not have good enough emergency plans in place, which is why they did not have enough stockpiles of PPE and had to panic buy. They bypassed existing, scaled-up, British-based providers of PPE, and they chose shell companies that had no experience. They gave huge contracts and jettisoned good contracting procedures. Other countries managed to do it at the time, and we should have been able to do it, too.

It is fair enough to move to emergency contracting, to streamline and speed up contracting, but no checks on companies? No checks to see if the masks met NHS standards? Did no Minister intervene and say, “This is not right. Emergency procurement procedures do not mean no procurement procedures”? Did no Minister say, “Assure me that these companies can deliver. This is taxpayers’ money”? Did no Minister say, “Assure me that the VIP lane is not being used by mates, donors and pub landlords to get contracts ahead of actual PPE contractors”? Did no Minister say, “Assure me that the contracts ensure the taxpayer will not pay for faulty PPE”? It seems not.

What happened was wrong, and it is disappointing that Ministers keep defending it. If Ministers do not own this and admit it was wrong, they will not make the necessary changes, and it could well happen again. Everyone in the country knows it to be true that the first instinct of the Conservative party, if there were another pandemic or emergency tomorrow, would not be to go to correct procurement procedures and to make sure that our taxpayers’ money is not spent wrongly.

I will tell the House about two types of company. The first is Arco, and Members have talked about others. Arco is a Hull-based market leader in PPE production. It has 135 years’ experience, works with 110,000 customers and holds key framework agreements, including with NHS Supply Chain. It is very experienced in providing expert advice and appropriate and compliant PPE during epidemics, including foot and mouth, mad cow disease, swine flu and Ebola.

Arco has its own accredited product assurance lab, a 400,000 square foot national distribution centre and a sourcing team based in China. All of that was in place at the beginning of covid. It had PPE of the required standard manufactured and ready to go. It contacted the Government, and what was the reply? It was ignored. Its offers went unanswered.

PPE Medpro was not even a company until May 2020, yet it was awarded a £120 million contract to provide 25 million gowns and a £81 million contract to provide face masks. PestFix was a pest control company with net assets of £18,000 in 2019. Its director, Joe England, met the chief commercial officer of the Department of Health and Social Care, Steve Oldfield, at the 80th birthday party of Mr Oldfield’s father-in-law. PestFix was referred to the high-priority lane and went on to win nearly £350 million of contracts but was fined £70 million for delivering faulty masks and gowns.

There was the mobile phone case designer that recorded a £1 million loss in 2019 but was referred to the high-priority lane by a former Conservative party chairman and received a £13 million contract to provide PPE. Meller Designs was a fashion accessory company, but it was referred by the right hon. Member for Surrey Heath (Michael Gove)—David Meller was a donor to his leadership campaign in 2016—and it received £170 million of contracts.

Ayanda Capital was a family investment firm specialising in currency trading, offshore property and private equity—an obvious go-to for supplying PPE. It was referred by Andrew Mills, an unpaid adviser to the Board of Trade, which is chaired by the right hon. Member for South West Norfolk (Elizabeth Truss)—I advised her that I would be mentioning her. The problem is that Ayanda Capital provided £40 million-worth of unusable face masks, yet it still posted a £25 million gross profit in 2020. The list goes on.

What do we need instead? We need a national resilience strategy. We need a procurement Bill that is not full of loopholes. We need a whole-system approach, not this mad panic and “pick your mates to make money” approach. That is why this matters, and it is why we are asking to see the documents. I hope the whole House will support this motion and ensure that the Government get the most basic responsibility of Government right, which is to keep us safe.

Contact in Care Settings

Fleur Anderson Excerpts

Thursday 27th October 2022 Commons Chamber

[Fleur Anderson (Putney) (Lab)]

I am very keen to speak in this debate and to raise the experiences of many of my constituents. I am grateful to my hon. Friend the Member for Liverpool, Walton (Dan Carden) for introducing this debate, and to the hon. Members for St Albans (Daisy Cooper) and for Chatham and Aylesford (Tracey Crouch) for sponsoring it.

Many constituents I know experienced dreadful times with those restrictions during covid. In saying that, I pay tribute to all the care workers and care staff who worked tirelessly through covid and are still working to take care of care home residents. My daughter is a care worker, so I have seen the impact that this has had on her throughout the pandemic. I also express my condolences to all those affected and pay tribute to the campaigners for Rights for Residents, who have brought this campaign to the fore and continue to ask for action.

My hope is that we will hear from the Minister about some action to make the legislative changes we need to make a difference now and to ensure that we learn the lessons of covid and of all the painful stories and experiences we have heard, so that if we are ever in a pandemic again, the same actions are not taken. It is understandable that visiting restrictions were put in place to save the lives of vulnerable care home residents during covid, but they could have been done differently, with much more consideration for the fact that a visitor is not just a “nice to have”, but an essential part of care, and that leaving care home residents without visitors led to a huge deterioration in their mental and physical health.

Many constituents have written to me about the effects of that isolation and lack of contact with relatives during covid. As one relative of a care home resident said:

“As you are aware my mother-in-law died and that’s attributed to the effects of isolation and forced separation and it’s paramount that we learn lessons from what has happened going forward.”

I visited many local care homes myself—respecting all restrictions in place, obviously—and heard about the lasting effects that isolation is having on elderly residents and the disabled even now; for example, residents who have become very reclusive.

The Government must listen to those care home providers who are also demanding an end to visiting restrictions and are not happy with the status quo. Jeremy Richardson, then chief executive officer of Four Seasons Health Care, the UK’s third-largest care home provider, said:

“We are depriving people of their right to visitors, which is an absolute outrage. The government restrictions at the moment are making it very difficult to give people a quality of life… We run care homes. We do not run prisons.”

The restrictions must be evidence-based. In December 2021, an Oxford University study, conducted by a team of eminent scientists led by epidemiologist Dr Tom Jefferson, found evidence that many vulnerable residents died of thirst, starvation and “broken hearts” during the pandemic. They identified that almost 40% of excess fatalities were not caused by the virus, with many people dying of loneliness and neglect. Without the support of visitors, vulnerable residents were left to deteriorate and die.

“Neglect, thirst, and hunger were—and possibly still are—the biggest killers”.

It is clear that care home staff had a huge amount of additional work during covid, but visitors would have alleviated some of that.

The Joint Committee on Human Rights published a report on the human rights implications of the Government’s response to covid in September 2020 and a report on care home visiting during the pandemic in May 2021. Following on from those, it published a report on protecting human rights in care settings, which recognised the balance between the state’s requirement to protect the lives of care users and other rights, including the right to a private and family life, stating that,

“too often the correct balance has not been struck and too much has been left to individual care settings to determine”,

and that

“insufficient respect was given to ensuring meaningful contact between care users and their family members and loved ones”.

We need legislation to ensure that that does not happen again.

The Committee’s report recommended that care users be given,

“the right to nominate one or more individuals to visit and to provide support or care in all circumstances,”

subject to full infection prevention measures, and that the Government should,

“give the CQC the power to require care settings to inform them of any changes to their visiting status, and to report live data”,

so that there is transparency about changes in visiting rights. The Government have not yet responded to this report, as other hon. Members have mentioned, but I hope to hear a response today.

As we have heard many times in this debate, the CQC guidance is just not enough. Rights for Residents is calling on the Government to take urgent action to pass legislation that would give every care home resident the legal right to nominate at least one essential care supporter, who can maintain contact in all circumstances, regardless of outbreaks, lockdowns, variants and future pandemics, and to ensure that care homes are supported in returning to pre-covid, unrestricted visiting arrangements, without the need for appointments or limits on time, frequency or the number of visitors.

In this place, we have a duty to give a voice to those who do not have one, and to fight against injustice. I feel that this debate has done that. I hope it will be heard and that it will result in long-lasting legislative changes that will save lives.

Breastfeeding: Government Support

Fleur Anderson Excerpts

Tuesday 8th March 2022 Westminster Hall

[Fleur Anderson (Putney) (Lab)]

It is a pleasure to serve under your chairship, Mr Efford. I congratulate the hon. Member for Glasgow Central (Alison Thewliss) on securing this hugely important debate. I hope you can do all you can in the Chair to ensure that we have all the time allocated to this debate that we should have, because we have precious little time on support for breastfeeding, but it is vital to so many people.

I am glad that this issue is getting time in the House, and I completely understand how difficult breastfeeding is, why it is not possible for many women, which is totally understandable, and how often it needs support. The current lack of provision for breastfeeding support and the impact of not restoring services after covid will be the main subject of my speech, and that is what constituents have been contacting me about. I breastfed my four children for a total of five years, so I understand the need for support and also the need to weigh babies frequently and straightaway, alongside breastfeeding, especially at the beginning, which is something else that has been cut. It is heart-wrenching to know that many mothers in my constituency are not getting the support that was easily available for me. Breastfeeding is also intertwined with mental health and can strengthen maternal and infant resilience if it is properly supported.

The Minister knows Wandsworth well, so I am glad to be able to raise the situation there. We saw the near total disintegration of breastfeeding support in the community during covid, and it has not yet returned. Every single health visitor infant feeding team was deployed during the pandemic and every single children’s centre closed, so there were no drop-ins for breastfeeding support. Just one person was left across the whole of Wandsworth and the borough of Richmond during the pandemic to support all the mothers and babies there. That is ridiculous, because the need was the same, but the support was massively reduced. Although the voluntary sector stepped up, there is no substitute for good-quality and accessible statutory services. The Government need to provide urgent funding and support for these dwindling services and to find out which are not being reopened. They should do a survey of all the services to find out what was there before covid and what is there now.

One constituent wrote to me about her awful experience so far. She said that, since covid, a lot of breastfeeding clinics providing support to mothers have closed. The only local clinic that she has managed to find is a two-hour clinic on Fridays in Kingston, which is quite far away. Otherwise, there is no provision in Putney and no way of getting a baby weighed other than by going to A&E or asking for a health visitor—something that is very difficult to get. The Eileen Lecky clinic in Putney was fantastic and used to provide this service, but it has been closed and the building is entirely empty. Before this debate I checked when the clinic would reopen, because I hoped to bring some good news. I found out that it is closed permanently now. No one was told about this; it is absolutely shocking to everyone in the area.

So what do we need? We need proper Government support. I urge the Minister to do everything in her power to restore these NHS services—in-person, easily accessible services at pre-pandemic levels. We need networks of trained peer supporters. That requires a training programme, a co-ordinator, regular supervision and updating under a health professional. We also need a specialist IBCLC—international board certified lactation consultant—clinic for complex cases. It is unacceptable that in 2022 parents are being left on their own and in the dark during one of the most important periods of their lives and their children’s lives. The Government can and must do more.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mr Efford.

I associate myself with comments on the importance of thinking about the mums and babies in Ukraine at this time, given how difficult it must be for all of them.

I congratulate the hon. Member for Glasgow Central (Alison Thewliss) on calling for and securing this debate, particularly today, which is International Women’s Day. We often talk about many issues affecting mums, but very rarely do we talk about breastfeeding, so it is really important to have this debate. Ensuring that every baby gets the best start in life is really important. As we have heard, positive experiences during this period will have a significant impact on a child’s health and wellbeing, and will inform the course of the rest of their life. Although the hon. Member for Aberdeen North (Kirsty Blackman) did not get the chance to speak for long, I sense her passion on this subject and she made her points very well.

Breastfeeding provides significant health benefits for both mother and baby. It has been shown to reduce the prevalence of common diseases in babies, such as respiratory infections and gastroenteritis and the risk of maternal breast cancer, as well as offering protection against childhood and maternal obesity. Breastfeeding also promotes emotional attachment and parental wellbeing. However, as the hon. Member for Glasgow Central said, we need to be mindful of the women for whom it does not work. We must ensure that they get the support and reassurance they need. As the hon. Member for Bristol South (Karin Smyth) said, it can be a very difficult experience for some.

I want to reassure colleagues that the Government are taking this matter extremely seriously. We want to promote breastfeeding as much as possible. The latest available data from the infant feeding survey, which we discussed, shows that only 1% of mothers in England are still exclusively breastfeeding at six months. More than 80% of mothers who stopped breastfeeding in the first two weeks reported that they would have liked to have carried on for longer and that perhaps, with support, they could have done. Common reasons for stopping include a lack of access to support services, as we have heard today, both in the community and at work, while misinformation, inconsistent advice, negative experiences and sometimes even cultural barriers can also deter women.

There are significant disparities in breastfeeding rates across England and the UK. We heard today about some excellent experiences in Scotland and Northern Ireland. The prevalence of breastfeeding is particularly low among young mothers, those who left education before the age of 18, and those from lower socioeconomic backgrounds. That contributes to a cycle of deprivation and further widens disparities. I agree with the hon. Member for Glasgow Central: it is so important that we teach young girls about breastfeeding in schools, so they learn early on about its importance and what to expect when their time comes.

In light of that, I want to reassure colleagues that the Government are taking action to support breastfeeding and to make that support accessible to everyone who needs it. First, we have the healthy child programme, a national evidence-based programme of interventions to support parenting and healthy choices. It outlines all services that children and families need to receive if they are to achieve optimum health and wellbeing, including breastfeeding and infant support.

Secondly, we have the maternity transformation programme, which seeks to achieve the visions set out by Better Births. National guidelines have been published for midwifery and health visiting services to support breastfeeding. I want to take this opportunity to thank all midwives, health visitors, support workers and those offering peer support. I met March with Midwives just before this debate and I recognise the pressures those workers are under. Sometimes things such as breastfeeding support are reduced or taken away when there is pressure on the service overall. I recognise that, and I am very happy to work with the service to try to improve that.

Thirdly, we have the 2019 NHS long-term plan, which recognises the importance of improving breastfeeding support and sets out a commitment to ensuring that all maternity services have an accredited, evidence-based infant feeding programme by 2024. However, we need the staff and the resources to make that happen. I have heard that loud and clear. We also encourage parents to access support through the Better Health Start for Life campaign, which provides advice and information on breastfeeding.

However, for me the most exciting development is the Government’s vision for the best start for life programme. It is only in England, but I am very happy to work with colleagues in the devolved nations to share best practice. The programme will roll out support to the areas of the country that absolutely need the most help. I thank my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) for her inspirational work in this field.

The early years healthy development review has taken the Government’s commitment to improving breastfeeding rates and improving the support to be included as part of the universal offer for all parents and carers, which will include practical support with breastfeeding, early diagnosis of issues such as tongue-tie and help with formula feeding, which is more appropriate in some cases. The review heard repeatedly from parents about the positive impact breastfeeding can have on their confidence and self-esteem, as well as the value of breastfeeding support groups and peer networks.

In the spending review, the Chancellor announced a £300 million investment to transform family hubs and improve Start for Life services with £50 million for breastfeeding support services. Funding will be made available initially to 75 upper-tier local authorities where we feel the most disparities exist. We will be announcing very soon where those 75 authorities will be and where we can support breastfeeding in those communities. Those local authorities will be able to invest in increasing the range of breastfeeding advice, specialist and peer support, and out-of-hours support that is available in person, on the phone and digitally, creating breastfeeding-friendly environments that will help mothers meet their breastfeeding goals.

[Fleur Anderson]

I know that time is pressing; I thank the Minister for giving way. Has the Minister done any assessment of how many clinics there were pre-covid? That number of 75 local authorities is great, but what about everywhere else? Has there been an assessment of initial services, what has been cut and what has been reinstated?

[Maria Caulfield]

I do not have that information, but I was interested to hear about the experience in Putney. I will take that away because I spoke to midwives who were redirected during covid, but I am not aware of which services have and have not restarted. I am keen to look at that, so I will follow that up. I am happy to conclude, Mr Efford, if that would be helpful.

Oral Answers to Questions

Fleur Anderson Excerpts

Tuesday 1st March 2022 Commons Chamber

[Gillian Keegan]

The hon. Gentleman raises a very important point. Clearly, these are distressing enough times without having that commute and those travel arrangements on top of that, but sometimes the services are highly specialised. We are trying to get the right blend between access to highly specialised in-patient services and making sure that we increase community efforts. We have been working very hard to ensure that there are more community efforts, but we have also invested £10 million more in capital for more beds to make sure people can get treatment closer to home.

[Fleur Anderson (Putney) (Lab)]

18. What assessment the Government have made of the adequacy of support for young carers.

[The Minister for Care and Mental Health (Gillian Keegan)]

We have introduced significant changes to support for young carers, with statutory entitlements to young carers’ assessments from April 2015. Local authorities are held to account for such assessments and support through the social care inspection framework. Further, as we set out in our adult social care White Paper, we will amend the school census at the earliest opportunity to include young carers, allowing us to establish a wealth of evidence on this cohort.

[Fleur Anderson]

I welcome more information being found out about young carers, because this is a hidden health crisis. A constituent came to see me. She is a young person now and has been a young carer for many years. The impact on her educational attainment, physical health and mental health has been devastating. There are 800,000 young carers in the UK, with 800 of them in Wandsworth where support services have been slashed. Does the Minister recognise the impact of that unpaid child labour and does she have a plan to tackle it?

[Gillian Keegan]

Very much so. Young people should be protected from inappropriate and excessive caring responsibility, and adult and children’s services need to work together better. We recognise, though, the lack of hard data and evidence on outcomes for young carers. That is where we are and that is why we have made the commitment, with the Department for Education, to amend the school census. We intend to introduce that as early as 2022-23 and each year thereafter. The data will be collected at primary school and secondary school, so we will be able to look at all kinds of outcomes for this particular cohort and take actions.

Covid-19: Forecasting and Modelling

Fleur Anderson Excerpts

Tuesday 18th January 2022 Westminster Hall

[Fleur Anderson (Putney) (Lab)]

Thank you, Sir Edward; it is a pleasure to serve under your chairship. I congratulate—I think—the hon. Member for Isle of Wight (Bob Seely) on securing the debate, because I welcome impartial and honest interrogation of the science, as well as decisions made over the last two years that have been important for our country. I also welcome extreme scepticism about some of the decisions made by the Government. This debate has not been an honest and independent inquiry into the science, however. It clearly comes with an ideological bent, so it has to be taken in that light.

I also begin by paying tribute to our public servants and Government scientists.

[Mr Baker]

Will the hon. Lady give way?

[Fleur Anderson]

I think I will make some progress first.

[Mr Baker]

I am not being rude; I just want to ask a question about what the hon. Lady has said.

[Fleur Anderson]

The hon. Gentleman has not even heard what I have to say yet.

[Mr Baker]

The hon. Lady said that we have made points that require an ideological bent. I invite her to look at what I said and identify at least three points that required any kind of ideological justification. Contrary to the point made by the hon. Member for Argyll and Bute (Brendan O'Hara), nothing that I said required libertarian political philosophy.

[Fleur Anderson]

That was another speech. I have never been in a room with so many software engineers who are also MPs. I begin by paying tribute to our public servants, our Government scientists, epidemiologists, and the scientific community who have worked tirelessly and put everything on the line to keep the public safe. That is what they have been trying to do over the past two years: keep people safe and save lives—and they have. They have shouldered the fear, anguish and hope of an entire nation that was experiencing deep trauma. They have, magnificently, been prepared to put their head on the block, if needs be. I hope the Minister will agree with me that it is very disappointing to hear them come under attack today from certain colleagues, despite everything that they have done.

I would remind those who seek to attack SAGE and our Government scientists that, while they were looking forward, planning and working hard on the evidence of what the virus might throw at us next, it was freshers week in Downing Street. They are not the enemy here. In fact, had a bit more attention been paid to their models, had there been more modelling before the start of the pandemic and had more action been taken in February and March 2020, thousands of lives could have been saved. It is not modelling that is the intrinsic problem here—it is decision making.

Modelling is a hugely important tool for managing epidemics that is tried and tested, with constant efforts to improve it. I agree with earlier comments that there should be more models; there should be models about the impact on mental health, education, poverty and models to learn from other countries in order to inform our decisions. As Graham Medley, one member of SAGE, explains very clearly, models are not predictions and are not meant to be seen as such; they are the “what ifs” that can be used by Governments to inform decisions and guide them as to what they might need to prepare for, which should include the worst-case scenarios—that is a crucial distinction. Accurate predictions cannot be made with such an unpredictable virus, when individual behaviour is also unpredictable, so models and scenarios are the best tools to give us the parameters for the decisions that will be made. As Graham Medley said, SPI-M—the Scientific Pandemic Influenza Group on Modelling—the sub-committee of SAGE that he chairs, produced

“scenarios to inform government decisions, not to inform public understanding directly. They are not meant to be predictions of what will actually happen and a range of scenarios are presented to policymakers with numerous caveats and uncertainties emphasised.”

Who would want it any other way?

My question to the sceptical Members present here today is: what is the alternative? We need to have those parameters. The alternative is guessing without parameters and knowledge.

[Mr Baker]

I am very happy to answer that question.

[Fleur Anderson]

I am going to move on. I do not want another speech from the hon. Member, given the time constraints. I am waiting for the Minister to answer my questions.

The Public Administration and Constitutional Affairs Committee also had problems with the communication of the modelling. It is there that I might have some common ground with the hon. Members who have spoken earlier. The Committee said in its report last March that communication has not always been transparent enough, and accountabilities have been unclear. I agree with this. If the time is not taken carefully to explain what modelling actually is to the public and media, and instead room is allowed for scenarios to be interpreted as predictions, inevitably the practice of modelling and forecasting will be rubbished and scoffed at and Government scientists blamed as doom-mongers. Not communicating the data and models properly creates more uncertainty and misery for small businesses, who have been asked enough as it is, as we saw over the Christmas period.

[Greg Smith]

Will the hon. Member give way?

[Fleur Anderson]

No. The PACAC report makes it clear that no one in Government has taken responsibility for communicating the data. The report states:

“Ministerial accountability for ensuring decisions are underpinned by data has not been clear. Ministers have passed responsibility between the Cabinet Office and Department of Health and Social Care,”.

That is why, as a member of the shadow Cabinet, I am responding to this debate. There are questions about the use and communication of the data.

I want to come to why we needed to rely on modelling and forecasting. Significant mistakes made throughout the last 10 years of Conservative government are the problem. There could have been much better information, and we could have been much better informed, if there had been better pandemic and emergency preparedness.

[Bob Seely]

Will the hon. Member give way?

[Greg Smith]

Will the hon. Member give way?

[Fleur Anderson]

I will give way—

[Sir Edward Leigh (in the Chair)]

Order. I think we need to move on.

[Fleur Anderson]

I agree, Sir Edward. Labour invested in pandemic planning in the Civil Contingencies Act 2004, but the Tory Government did not continue that investment. Operation Winter Willow in 2007 involved 5,000 people from all walks of life simulating a pandemic. The need for PPE, PPE training and wide-ranging social and economic disruption was identified. The Labour Government, then led by Gordon Brown, made heavy investments in pandemic planning.

Cut to 2016, Operation Cygnus made 26 key recommendations about PPE, urgent and drastic improvements to the NHS, and the likely impact on care homes. Most of that was ignored. PPE training stopped, stocks were run down—much of it left to go out of date—and there were no gowns, visors, swabs or body bags at all. The UK pandemic plan was mothballed and we were unready for the pandemic. No wonder we had to rely so much on modelling and forecasting.

We could have been much more ready. The Cabinet Office should have stepped up to enable cross-departmental organisation, and organisation with the devolved authorities based on plans, informed by the results of exercises and earlier modelling, but it did not. I hope that the Minister will echo that, distance herself from some of the earlier comments and criticism of our scientific community and respond to the points about pandemic planning and what we can learn.

Finally, I know that the hon. Member for Isle of Wight (Bob Seely) has asked for an inquiry into modelling. I welcome the inclusion of that in the covid inquiry. I hope that the Government will launch that inquiry. They have appointed a chair, but that chair is waiting for the powers she needs to begin getting evidence from scientists, software engineers and everyone she needs to hear from.

[Sir Edward Leigh (in the Chair)]

Will the Minister allow a short time for closing remarks?