NHS Dentistry in England

Graham Stringer Excerpts

Wednesday 22nd June 2022 Westminster Hall

[Derek Thomas]

I thank the hon. Gentleman for his intervention.

It is probably fair to say that although the responsibility lies with the Minister here today, it is not her responsibility, or even in her power, to ensure that every member of the British public can access NHS dentistry, simply because NHS England, or indeed any part of the NHS, does not commission enough dentistry to cover the whole population. Perhaps the Minister will clarify today the Government’s expectation regarding access to NHS dental care, and say whether there is a right for everybody, whoever they might be, to access that care. However, it is a very important point that has been raised. It surprises people that we do not commission enough dentistry to meet the needs of every one of our constituents.

It is not enough to blame the pandemic, although it has certainly not helped. I was raising the state of NHS dentistry in Cornwall before we had a single case of covid in this country. Over two years ago, I spoke about the difficulty of recruiting and retaining dental staff. At Prime Minister’s questions two years ago, I raised the shocking results of the lack of access to NHS dentistry for children in Cornwall. I also told hon. Members that these inequalities needed to be addressed quickly and creatively.

Outside this House, I have been working to improve access to dentistry in the constituency, most recently by getting the council to overturn a decision not to allow electrical works to proceed in St Ives that would have delayed the opening of a new dental surgery until the autumn. I have been meeting the regional health commissioners and Cornwall’s public health officers to discuss dentistry on a regular basis, and I cannot fault their speed and creativity. Their south-west dental reform programme has been working hard to improve access by helping to reopen a surgery in Hayle and in St Ives, piloting child-focused dental practices, and developing its own evidence-based workforce plan, but the Government must lead the way. Resolving these oral health inequalities is not just this Minister’s responsibility; it will require a cross-Government approach.

NHS England has launched a drive to recruit dental professionals to the south-west, but a key challenge in Cornwall, and maybe other parts of the country, is finding housing for those who want to take up a job in dentistry. I am working on that issue with the Department for Levelling Up, Housing and Communities. The national food strategy was a wasted opportunity. We could have extended the sugar tax, which has successfully incentivised the reformulation of sugary drinks. That would have helped oral health as much as health in general. I shall continue to argue for a national food strategy that is truly strategic, even if the Government have made a tactical withdrawal from tax rises to support public health.

The Minister has responsibility for the dental contract. In oral questions in January, she agreed that the contract was

“the nub of the problem”.—[Official Report, 18 January 2022; Vol. 707, c. 195.]

She said in February,

“there is no doubt that the UDA method of contract payments is a perverse disincentive for dentists. The more they do, the less they seem to be paid. I for one certainly do not underestimate the problems that that causes dentists, and I can see why many hand back their NHS contracts.”—[Official Report, 7 February 2022; Vol. 708, c. 780.]

I could not have put it better myself. I have asked dentists in my constituency if they would prefer to see increased budgets or reform of the UDA contract, and they asked for reform.

There are two main issues with the dental contract, both of which are not just obstacles to dental health but actively create problems for the future. First, the current system does not focus on prevention. When units of dental activity are the sole measure of contract performance, there is no incentive for preventative work; nor is there an incentive to make the best use of the whole dental team’s skills when the practice cannot make a claim for payment for a course of treatment purely because it was initiated by someone other than a dentist.

I made sure that the title of the debate referred to NHS dentistry not NHS dentists. We need to recognise the contribution of the whole team of dental professionals —dental nurses, hygienists, therapists and technicians—and use them. Again, this is about not just saving money, but using professionals in the best way we can. Yesterday I spoke to a dental nurse who works with people in care homes. If she wants a resident to switch to a high-fluoride toothpaste, she has to get a dentist to prescribe it. Our regional dental commissioning team has been running a pilot to take supervised toothbrushing conducted by dental nurses out to the community. Given that more five to nine-year-olds are admitted to hospital for tooth decay than for any other reason, this work should be at the heart of NHS dentistry, not something that is topped up by flexible commissioning.

Second, the UDA method does not properly reward dental practices for their work. A dental practice is faced, in effect, with a UDA cap for an entire course of treatment, which means when a patient has complex needs, the money involved does not even cover the overheads of the practice. The predictable result is that dental practices are moving away from NHS work. Around 3,000 dentists in England have stopped providing NHS services since the start of the pandemic. Every time a dentist leaves the NHS and is not replaced, approximately 2,000 people lose access to dental care. If you cannot do the arithmetic in your head, Mr Stringer, 3,000 times by 2,000 is 6 million, so 6 million patients have lost access to a dentist just over the course of the pandemic. For every dentist leaving the NHS, another 10 are reducing their NHS commitment by a quarter on average; that is another 500 patients losing access to an NHS dentist. According to the British Dental Association, 75% of dentists plan to reduce the amount of NHS work they do next year.

The fewer dental practices there are doing NHS work, the more pressure the remaining practices are under. A recent BDA members survey found that nine in 10 owners of dental practices committed to NHS work found recruitment difficult, with 29% of vacancies going unfilled for more than a year. That is nationwide, but one provider in Cornwall told me that their surgeries were unused 52% of the time due to shortages of dentists and nurses. The vast majority said that it was the UDA contract that was the biggest factor in their recruitment difficulties. The Minister said last week that the Government are serious about reforming the dental contract, but I want to press that point. It is not enough to be seriously planning a reform; we must be planning serious reform. Tweaks to the existing system are not enough when the contract is fundamentally flawed.

I have focused on the contract because we need the Minister to focus on the contract. Other Members will no doubt raise the issue of recognising overseas qualifications, passing the section 60 order that would give the General Dental Council discretion over qualifications, maintaining the mutual recognition of professional qualifications with Europe and extending that to the Commonwealth, and expediating the process for experienced candidates to register with the NHS. Dental care professionals need to be allowed to initiate treatments. The issue of funding will come up—for a catch-up programme of overseas registration exams in the short term, and university places in the long term—but it is striking how many of those proposals are cost neutral. We could even save money by catching mouth cancer in the early stages when it is more easily treated.

To quote the Minister, the contract is the nub of the problem. I urge her to commit to a firm date when we will see the end of units of dental activity, and a better contract focused on prevention and increasing access.

[Graham Stringer (in the Chair)]

I have indications from six Members who wish to speak. I intend to call the Opposition spokesperson at 3.40 pm. You can do the arithmetic—it is fairly straightforward—I do not intend to impose a time limit unless Members indulge themselves.

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[Feryal Clark]

I will make progress because I have a lot to say in only five minutes.

Here we are again. After more than a decade in power, the Conservative party has absolutely nothing to show for it, other than a record of complete and utter failure. The Tory Government made a commitment to reforming the contracts in their 2010 and 2017 manifestos, so I would be fascinated—as, I am sure, would other hon. Members—to hear from the Minister what on earth has been happening for the past 12 years. If she is happy to associate herself with that record, that is her decision, but I would be embarrassed and ashamed, to be frank.

The Minister is presiding over a national scandal. It is simply not good enough to keep shirking responsibility. Whenever the Government have had something that looks like a plan, it has been woefully inadequate. I am sure that the Minister will—as other Members have—tell us about the £50 million of extra funding that we have heard so much about, but if she thinks that it has made a blind bit of difference, she is very much mistaken. I have been made aware that Yorkshire and the Humber, for which £8.3 million was allocated, drew down just £2.3 million. Barely any of that money was used by general dentists; it was used predominantly by hospitals.

I would be grateful if the Minister could confirm or deny whether yesterday, after being asked about this matter by my hon. Friend the Member for Sheffield Central, her answer was simply that we should wait for the data. At best, we have had a mixed response on when we will receive the full breakdown of how much of that £50 million was taken up. Can she confirm whether we will receive that data before the summer recess?

If that funding was designed to regain the confidence of dentists and encourage them to increase their NHS activity, it has completely and utterly failed. Across England, the number of patients being seen by an NHS dentist actually dropped by 22% overall between March and April. As the Minister will be aware—I mentioned this yesterday—there was a 34% drop in her own constituency. I ask her again: how can she expect dentists across England to have confidence in her when it is clear that she does not even have the confidence of dentists in her own patch?

One way of building trust would be to communicate with the profession. Yet just eight days before the start of the next quarter, dentists have no idea of the targets that they will be working to. Can the Minister confirm whether that announcement will be left until the eleventh hour once again? Furthermore, can she confirm that, as the Secretary of State said yesterday, the target will be 100% of pre-pandemic activity?

Let me remind colleagues of a story that my hon. Friend the Member for Lancaster and Fleetwood (Cat Smith) told in yesterday’s debate. A constituent of hers came to her surgery and placed on her desk the teeth that he had pulled out of his own mouth with pliers. Does the Minister think that such stories, which are now disturbingly common, are acceptable in 21st century Britain?

I am sure that the Minister will say once again that the Labour party is just shouting from the sidelines and does not have any plans, but when it comes to NHS dentistry, her Government have nothing to show for their 12 years of shouting from the centre circle. “Shouting” is a generous description, in the light of the Minister’s refusal even to speak to dentists at the Association of Dental Groups conference just a few weeks ago.

This Government might have a track record of failure, but it does not need to be that way. It is time for meaningful action that will make a difference to patients. I look forward to hearing the Minister’s answers.

[Graham Stringer (in the Chair)]

We are not short of time, but will the Minster leave a minute or two at the end of her speech for the mover of the motion to wind up?

North East Ambulance Service

Graham Stringer Excerpts

Monday 23rd May 2022 Commons Chamber

[Maria Caulfield]

I can reassure the hon. Gentleman that NHS England is doing work on workforce planning, which is crucial to ensuring that we have not just the right number of staff, but the right skills mix. I can also reassure him that performance in the ambulance service nationally has improved from March to April.

The ambulance service has been working under severe stress during the pandemic and in dealing with the ensuing backlog. We need to be mindful that although these are tragic events, the vast majority of ambulance staff are working extremely hard and caring for patients.

[Graham Stringer (Blackley and Broughton) (Lab)]

This is an appalling scandal and tragedy. Unfortunately, it follows a whole series of events that everybody in this Chamber could name, from Morecambe Bay to Mid Staffs to Bristol. The Minister claims that the NHS is open and that it has a learning culture when genuine mistakes are made. That is good rhetoric, but I am afraid that it is not the reality. What will she do to make it a reality? Last week, The Economist estimated that 1% of all deaths in this country are down to mistakes in the NHS.

[Maria Caulfield]

As I have said to other hon. Members, mistakes are always going to happen; that is human nature. The difference is that we are trying to introduce a culture of openness and learning in the NHS so that staff feel confident in coming forward, and so that when a mistake does happen, lessons are learned to prevent it from happening again.

Let us look at the record of this Government. It is this Government who are introducing a commissioner to oversee patient safety across the NHS. It is this Government who have introduced a statutory duty of candour so that when mistakes happen, patients and their families are notified and the process of learning starts. It is this Government who have introduced an early notification system specific to maternity—

Men’s Health Strategy

Graham Stringer Excerpts

Tuesday 22nd March 2022 Westminster Hall

[Graham Stringer (in the Chair)]

Nick Fletcher will move the motion and I will then call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention in these 30-minute debates.

[Nick Fletcher (Don Valley) (Con)]

I beg to move,

That this House has considered the potential merits of a men’s health strategy.

It is a pleasure, as ever, to serve under your chairmanship, Mr Stringer. Although this is only a 30-minute debate, I would still like to extend my thanks to the Backbench Business Committee for granting the time to discuss this extremely important issue. I am pleased that the Minister for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), will respond, given her very positive contribution to the Westminster Hall debate on prostate cancer earlier this month. I am confident that she will give a positive response today.

Over the past year, the all-party parliamentary group on issues affecting men and boys, which I chair, has continually heard from a range of national and international experts that there is a need for an improved focus on and a far more co-ordinated and strategic approach to men’s health in England. This approach has been adopted elsewhere, in countries, such as Australia and Ireland, which have their own men’s health strategies, as does the World Health Organisation in Europe. We all agreed that there are serious challenges in men’s health.

It is important to place on the official record that nearly one in five men do not live until they are 65, with an increasing gender age gap; that 13 men take their own lives every day; that men in some parts of Kensington and Chelsea live 27 years longer on average than those in some parts of the north; that one man dies of prostate cancer every 45 minutes; that nearly 6,000 men die an alcohol-related death every year; and that two thirds of men are overweight or obese.

The troubling matter for me is that the situation is not improving but seems to be getting worse. The time has come for the Government to take a fresh and strategic approach that is in keeping with their positive levelling-up agenda and their What Works approach to policy making. The Government approach to men’s health is based on individual conditions and is disease-based. However, as well as not having the impact that we would hope for, such an approach looks only at the outcomes of poor men’s health, not at the causes. To me, that is key.

We need to address and prevent the underlying causes and barriers that have a negative effect on men’s health, while also making the health system more responsive. For instance, if we continue to address suicide, alcoholism and obesity as separate issues, we will fail to see that they are often a result of similar circumstances. Why are men who live in economically disadvantaged areas dying from a whole range of illnesses far earlier than men who live in wealthy areas? There is no innate biological reason for that. We need to strategically join the dots on the causes, not place the outcomes in separate buckets labelled condition A, B or C, as is currently the case.

A men’s health strategy would ask more questions of the health sector. What of the gender age gap? It is a well-known fact that women live longer than men. Why is that? It was not always so. This is not something that we should just shrug our shoulders at and accept as normal. I want all men to have a long life and for those lives to be lived in a state of wellbeing. I am sure that nobody in the country would disagree with that ambition.

Another issue is that despite making up 75% of all suicides, men make up only 34% of those referred for specialist therapy. Why is that? Is it because they are not being referred or because suicidal men are not accessing the health system in the first place? It could be a combination of the two, of course, but why are men not getting the support they need, and what is being done to address that? We need to look at this at a systemic level. Of course, men need to adapt and help themselves, but the final responsibility has to be on society and the health system to change to help men.

During the APPG’s evidence sessions, the experts raised a number of points that struck home. When I visit my GP, which is thankfully rarely, I always notice how few other men of working age are there. We have to work out why and address that. Is it hard to get time off work? Are GP opening hours flexible enough? Do men fear that their bosses or workmates will raise questions about whether they are healthy and fit enough to do their job? Do they just get on with it? It could be all or none of those reasons.

Campaigns to encourage men to access the health system are necessary and welcome, but deeper issues need to be addressed. We also need to ensure that we do not look at men’s health from a negative perspective. Our approach should be based on the needs of men and boys, rather than on men and boys having to accept what they are given. That is the positive What Works approach taken by a number of men’s health strategies around the world. I hope that the Government can draw comfort from the fact that they do not need to start from scratch in devising a strategy, because strategic work is already being done in Ireland, Australia and elsewhere.

In addition, a host of leading men’s health experts and charities in the UK are ready and able and want to help the Government. The Government should look at the great work that is being done on men’s health in Leeds—everything good in life starts in Yorkshire. The Government could also harness the knowledge, expertise and help provided by a number of great, growing and pioneering organisations that support men’s health, including, to name a few, Andy’s Man Club, UK Men’s Sheds, Prostate Cancer UK, Lions Barber Collective, Men Walking and Talking, MANvFAT, Mates in Mind, Football Fans in Training, and Black Men’s Health UK.

In addition to their great work, all of those organisations know that men do talk and take action on their health when the right environment is created. Many of those initiatives also prove the importance of taking support to where men are, not to where it is thought that they should go—many experts have made that point. I am sure that those organisations are all on stand-by to help the Government, as are a number of health bodies, such as the Men’s Health Forum and the Patients Association, which support the proposal to create a strategy, with the former leading a national campaign.

Since becoming a Member of Parliament in 2019, I have been struck by how the Government are taking a fresh, constructive and positive look at all policy areas. Old ways of thinking are no longer taken as read. We can see that in the field of women’s health, where the Government are introducing a strategy for the first time, which I am sure all of us in the House support. To be clear, that is not a reason in itself for a men’s health strategy, but it does signal the need to have a consistent, cross-Government approach that takes into account specific, gender-based aspects affecting the health of women and men. Without a change in policy, it would be incumbent on the Government in the coming months to explain, with hard evidence, why and how their current approach is improving men’s health.

My concluding point is that a men’s health strategy would benefit not just men and boys but the women and girls with whom they share their lives and society. They all have fathers, uncles, brothers, cousins. This is a strategy for the nation as a whole. It would also be cost-effective, saving the health service millions of pounds in treating illnesses, and helping employers in reducing sickness levels. It is a win-win situation and would lead to a healthier, happier and more productive society for all. The Government have an ideal opportunity, with the coming White Paper on disparities, to start the ball rolling, and I am confident that they will take it. I look forward to hearing the Minister’s comments on this incredibly important issue.

Future of the NHS

Graham Stringer Excerpts

Monday 31st January 2022 Westminster Hall

[Matt Vickers]

This is a debate that we have in every election campaign, and other than the issues around dentistry, which I am sure we will come to, the NHS remains free at the point of use. I will fight the corner to keep it that way, and I am sure that the hon. Gentleman will do so as well.

[Graham Stringer (Blackley and Broughton) (Lab)]

I think everybody in this room would agree with the principle that the NHS was founded on—care that is free at the point of use—but the NHS has had many structural forms since its inception immediately after the second world war. My concern is that its current form and the proposals that the Government are bringing forward further centralise the NHS, and waste further money on bureaucracy, mimicking the private sector and creating an artificial market. Does the hon. Gentleman agree that that is a waste of money, and that the NHS should be decentralised in order to provide better services to local communities?

[Matt Vickers]

I am sure we are going to hear about the ways in which these structural reforms will take place with that very aim in mind. I am going to try to get through my speech, because I am sure that Members would prefer for everybody to get in and to hear from the Minister, who is wiser on this issue than I am.

In my view, the Health and Care Bill does not represent an attempt to create a “pay for play” system—quite the opposite. While I am sure the Minister will go into detail about this point in his response, my understanding is that the Bill is largely the work of the NHS itself, inspired by NHS England’s own desire to restructure its organisational system to be more efficient and effective. It builds on the NHS’s own long-term plan, as set out in 2019, and the NHS people plan, which was published in 2020. Many of my conversations with leaders from my local NHS trust suggest that the answers to improving health outcomes require multi-agency working and empowerment of local health agencies, and my understanding is that the reforms and structural changes in the Bill set out to do exactly that.

One point on which I strongly agree with the petitioners is the need to drive value for money within our NHS, reducing management costs and excessive use of consultants, so that the huge increases in funding for the NHS can actually reach the frontline, not just fund more fruitless layers of bureaucracy. I am hopeful that the Minister will update us on what is being done to drive efficiency in that regard. Another point that I fundamentally agree with is the petitioners’ view that private finance initiative contracts have no place in our NHS. I know all too well the debilitating effect they have on the ability of the NHS to administer care across our country. Nationally, PFI contracts cost our NHS £1 billion a year and restrict numerous hospitals across the breadth of Great Britain.

I have seen at first hand how PFIs have damaged our local services in the Tees Valley. South Tees Hospitals NHS Foundation Trust, in particular, has been plagued by a dodgy new Labour PFI contract. The James Cook University Hospital was completed in 2003, but its PFI contract does not run out until 2034, and will cost over £1.5 billion. The trust currently has to meet annual payments of £57 million a year—more than £1 million every week. Of course, hospital upgrades and rebuilds are expensive, but that trust is paying £17.5 million over and above what an equivalent Treasury-funded hospital would cost annually. Shockingly, that is enough to pay for more than 530 nurses. It is ludicrous.

Even if there were not an extra 530 nurses at South Tees, there is so much the hospital could do with this money, such as investing in its building, equipment and staff to help improve health outcomes and inequalities. Excessive costs from historic PFI contracts are listed as the largest single contributory factor to the hospital’s troublesome financial position. At time when retention is a huge issue for our NHS, this money would be crucial to making a substantial difference to the working lives of our NHS heroes. I am glad that in 2018 a Conservative Government decided that PFI contracts would be phased out. However, hospitals up and down the country are now stuck dealing with a Labour legacy that has damaged our NHS, our people and our ability to tackle health inequalities across this country.

Public Health

Graham Stringer Excerpts

Tuesday 14th December 2021 Commons Chamber

[Wes Streeting]

My hon. Friend makes such an important point. Going back to the staff surveys, particularly given that the overwhelming majority of staff are vaccinated, it is not that they do not want their colleagues to be vaccinated, but that they have concerns about the way in which the Government are going about this. We accepted from the Government and from NHS England a very clear view that omicron has raised the stakes in this regard, which has had a big bearing on our position. It is very difficult for me and my colleagues on the Labour Benches to put ourselves in a position that is on the other side of the argument from the NHS and from the public, but the point about engagement is really important. The Government must work with and take the workforce with them. It is not good enough for us to just clap for the NHS, or clap for carers; we must work in partnership with them and respect that these are people who have given their lives to public service and caring for others. They do care. They will instinctively be on the right side, but they just need some persuasion, some patience and genuine engagement and that is where the Government have gone slightly wrong.

[Graham Stringer (Blackley and Broughton) (Lab)]

My hon. Friend started off his speech in an excellent way and has got better as he has gone through it. I say that, but I will almost certainly not be in the same Lobby as him on some of the votes this evening. There is a general point to the specific point that he is making on vaccines, which is that the Government should be clear, explicit and transparent on every issue that they raise if they want to take with them people who are not just worried about vaccines but worried about this whole affair. Repeatedly, the Government have refused to do a cost-benefit analysis on the impact of their policies. We have before us now a number of statutory instruments without impact assessments. Does he agree that that information should be available?

[Wes Streeting]

Let me say to my hon. Friend that, in his intervention, he started off well, dipped in the middle and then got better at the end. He made some absolutely fair points about impact assessments and transparency. In fact, I can see the Vaccines Minister waving impact assessments at me, so I am sure that she will make them available to my hon. Friend.

It comes back, as we have discussed at various points today and previously in relation to these sorts of restrictions and measures—it is how I began, and will begin to close, my contribution—to how we really cannot be complacent when it comes to public support, public compliance and public consent for the measures that we are considering. We know that we have asked so much of the British people and they have played their part. We also know that recent events have dented their trust and confidence and their willingness to comply, because they have seen No.10 saying one thing and doing another. That makes it even more important that, when we discuss measures that impact on people’s lives, livelihoods and liberties, we have these sorts of exchanges, look over the evidence rigorously, test each other’s assumptions and come to a conclusion.

With some of the exchanges that we have heard today, people across the country on both sides of these arguments can at least take some reassurance from the fact that, when these matters are under consideration, we do take them seriously. The Government could do a little better sometimes on bringing measures forward in advance of their implementation and on setting out the rationale and argument, and not just assuming that, because measures have been supported by the public previously, they will be supported today. I think we have public support for the measures under consideration this afternoon, but we should not be complacent about it. That is why it is right that we spend so much time exploring these issues.

--- Later in debate ---

[Graham Stringer (Blackley and Broughton) (Lab)]

As you know, Madam Deputy Speaker, I was trying to help you with the intervention by withdrawing from the list, but I am grateful to be on top of the list for the Labour Benches.

I agree with my right hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer) the Leader of the Opposition when he says that the Prime Minister is a threat to public health. I think that that is absolutely right. I draw a different conclusion from my hon. Friends on the Labour Front Bench on how we should respond: not by being irresponsible but by taking a look at the way the Government have dealt with the whole of the covid crisis from the very beginning to what they continue to do.

I am a member of the Science and Technology Committee. Together with the Health and Social Care Committee we produced a 150-page report. I hope that right hon. and hon. Members have had the time to read it. They may not agree with its conclusions, but it contains very valuable information. The key point, which a lot of the press missed, was not that the Government followed the science on the issue but that they got into a groupthink with the scientific advisers and did not challenge them. They assumed that science was something handed down on tablets of stone, whereas it is not. It is a process and it needs challenging by those of us who have responsibility in this House for making laws and policies, and by other scientists. We seem to be repeating that process.

My Committee had as a witness this morning Susan Hopkins. Let me say that at best—if I can use a word somebody else used—the advice we were getting from her as an adviser was opaque. The information we were getting was opaque when it should be transparent. This time last week, the Deputy Prime Minister stood up and said there was no plan to go to plan B. Some 36 hours later, we were starting plan B. Why was that? What was the scientific advice given?

We were told fairly definitively that no such advice was given to change the view. What changed the view was that the Prime Minister was in a state of crisis and under pressure from his own Back Benchers and everybody else. That is not a sensible way to make decisions. It is not a sensible way to make decisions to put forward statutory instruments that say—the Under-Secretary of State for Health and Social Care, the hon. Member for Erewash (Maggie Throup) was waving a sheet about, which may or may not have been the impact assessment—that no impact assessment has been done.

[Mr Steve Baker]

I have in my hand the impact assessment for vaccination as a condition of deployment in health and care providers—I was not able to get in earlier. I feel confident that the Front Benchers will know that the estimate is that 88,000 people will leave the health sector, 73,000 will leave the NHS, 15,000 will leave the independent health sector, and 35,000 workers will leave domiciliary care. Does the hon. Gentleman agree that that is reason enough to vote against imposing this on the nation?

[Graham Stringer]

That is very interesting. It is also interesting that papers circulated by the Vote Office said there was no impact assessment. That does not impress me.

The point I was just about to make—I do not know if other hon. and right hon. Members have noticed this—is that the 355-page Act passed at the start of the epidemic, the Coronavirus Act 2020, is barely being used. The Government could have used the Civil Contingencies Act 2004 to bring in some of the restrictions that they have placed—maybe necessarily, maybe unnecessarily—on people’s freedoms. The difference between the 2004 Act and the Public Health (Control of Disease) Act 1984 is quite simply that much less scrutiny is available under the latter. Once regulations are passed, if there is not a sunset clause, they last. The Government should not be rewarded for unnecessarily using tough authoritarian legislation when other legislation was available that would have allowed more scrutiny.

The Government have refused to give information. My hon. Friend the Member for Ilford North (Wes Streeting) began his speech by saying that different people have different views and weigh the factors of civil liberties and health in different ways. That is absolutely right, but the Government will not tell us the costs and benefits of their policies. We now know that three quarters of a million people have failed to be tested for cancer. This is not a win-win situation. Cancer patients who are yet to be tested will eventually die because of the decisions being taken, because services are not available; some people will die of covid.

To come to the right decisions, this House needs all the information available, but it is not coming from the NHS and it is not coming from Government Ministers. That is why I will not give the Prime Minister the benefit of my support for the way he has arranged to respond to this covid crisis.

Covid-19 Vaccinations

Graham Stringer Excerpts

Monday 20th September 2021 Westminster Hall

[Jack Dromey (Birmingham, Erdington) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Ghani, and I welcome the Minister to her position in Government and here today. One of the welcome innovations of parliamentary democracy in recent years has been the notion that the public can trigger debates by way of e-petitions, and we are here to debate two e-petitions that commanded significant public support.

The hon. Member for Carshalton and Wallington (Elliot Colburn) was absolutely right to talk about the development of the vaccines as a remarkable triumph of British science, and all those who have been involved deserve huge credit—not least because the consequence has been to save the lives of tens of thousands of people who would have otherwise have died. We in the Labour party are committed to following the science and, as has been said eloquently, we can see that vaccination is having a dramatic impact, reducing hospitalisation and preventing people from becoming very ill with covid. As the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) rightly said, it is absolutely vital that everyone who can get the vaccines should do so. We therefore need to send an unmistakable and united message from Parliament: by keeping uptake rates high, we can beat the virus. Anyone who is worried about the vaccine—there are many—should speak to health professionals about their concerns and receive proper advice. They should not be influenced by anti-vaxxer fantasists, whose advice is not just wrong, but dangerous to health and wellbeing.

[Graham Stringer (Blackley and Broughton) (Lab)]

I agree with the point that my hon. Friend is making. I was talking to a 14-year-old over the weekend, and she said that she had seen on the internet a magnet that was attracted to somebody’s arm because they had been vaccinated. Does my hon. Friend agree that the internet companies and the Government should get such nonsense taken down as soon as they can?

[Jack Dromey]

My hon. Friend is absolutely right. Some of the propaganda that we have seen, including on the internet, is positively pernicious. If anyone is seduced into believing it and, as a consequence, catches covid and dies because they are not vaccinated, those responsible bear should bear a heavy burden for what they are doing. Everyone with power, including the internet companies, needs to be more proactive and dynamic in ensuring that shameful propaganda is not propagated on social media.

Over the past year, we have seen the tragic impact of coronavirus on our communities. I stress once again that it is absolutely vital that the importance of taking the vaccine is constantly emphasised. I think of Jane Roche in my constituency, who lost her father and, five days later, her sister to covid. Jane remains distraught to this day, one year on. People such as Jane know all too well just how important it is that vaccine uptake remains high, so that no one should suffer the grief that she has suffered. Like other hon. Members who have spoken in the debate, I therefore strongly encourage everyone to get vaccinated for their own protection, but also for that of the wider community.

The Labour party calls on the Government to make a more direct effort to vaccinate those from communities in which vaccination rates are low, particularly young people. I hope that in her response, the Minister will be able to update us on the Government’s efforts to tackle the problems of low uptake.

On vaccine passports, in relation to the petitions before us, we understand why the public might be confused or anxious about perceived discrimination against those that are not vaccinated. I have to say that the Government’s approach to covid passports has been chaotic at times. There has not been consistent clarity from Ministers about what vaccine passports are supposed to achieve, how they would work and what would be expected from the public, businesses and workers, and that meant we had a degree of chaos over the summer and no real preparation before the winter. Two weeks ago, the then vaccines Minister, the right hon. Member for Stratford-on-Avon (Nadhim Zahawi), stood before Parliament to confirm the introduction of covid passports and stress their importance; days later, the Secretary of State for Health and Social Care said that they had been scrapped. No matter the measures being introduced, businesses, workers and consumers need clarity from the Government, not conflicting messages and rapid U-turns. We have therefore repeated many times that we would not accept any certification or passport scheme that was vaccine-only.

The Welsh Labour Government have made some interesting progress on this very issue. They followed the data and applied a mandatory risk assessment that takes into consideration the full risk posed, and then recommends a range of mitigations on that basis. For large venues, crowded events and close-contact businesses, such as nightclubs, the NHS covid pass application is mandated for use; that means using familiar mitigations such as masks, social distancing and ventilation in most business settings, based on the risk level. Use of the NHS covid pass gives people the option to present a negative test result as an alternative to full vaccination.

We do not support the introduction of any scheme that provides access to a service for only fully vaccinated people. Free testing should therefore remain widely available so that we can identify and isolate the virus. The approach in Wales has been welcome in other respects, as it makes a clear distinction between venues such as local cafés on one hand and Wembley stadium on the other, where different mitigations for covid are needed.

We also do not support any potential covid pass scheme for access to essential services that does not get the balance right. That includes, but is not limited to, access to doctors and dentists, supermarkets and other essential retailers. We do not agree that vaccine passports should be used for day-to-day, routine access to the office, health services, dentistry or food.

On health and social care workers, we want everyone working in care homes to take up the vaccine—that is absolutely essential. The vaccine is safe and effective. I stress again: do not believe the sometimes poisonous propaganda of the anti-vaxxers. However, we do not support the case for compulsory vaccination. There are serious warnings from the care sector that the Government’s plan could lead to staff shortages in already understaffed care homes, which would have disastrous consequences for the quality of care.

Again, the UK Government should learn from the work done in Wales, which is running the fastest vaccination programme in the world, and has vaccinated a far greater proportion of its care staff than England. The Welsh Government have rejected compulsory vaccinations and have instead chosen to work closely with the care sector to drive up uptake, as well as valuing the workforce, including a proper pay rise. The Government should focus on driving up standards and retention of staff by treating care workers as the professionals they are, with improved pay, terms and conditions and training. We need all care homes and care workers to have proper personal protective equipment, regular testing and good training.

We are now approaching what is likely to be one of the most challenging winters that the national health service has ever faced, and the top priority must be to protect it. We urgently need a plan from Government that sets out the direction of travel in the next stages. Any plan for the winter period must, first, get vaccination rates up in areas where uptake is low; secondly, outline how and by when vaccinations for children will be rolled out; thirdly, finally fix the issues of self-isolation and sick pay; fourthly, provide proper ventilation in schools and public buildings; and, fifthly, provide a clear plan for businesses, workers and consumers. Those are significant steps the Government could take to greatly improve the country’s response to coronavirus. I hope that when the Minister responds, she will be able to outline in more detail the Government’s plan to fix those problems.

Once again, as other hon. Members have done cross party, I emphasise the importance of vaccine take-up. Covid-19 vaccines have saved thousands of lives and been crucial in protecting the national health service. It is critical that we maintain the protection the vaccine affords and send a clear and unambiguous message to all that vaccines work, and that anyone who can, should receive the vaccine.

--- Later in debate ---

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

Thank you, Ms Ghani.

I am grateful to my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) for introducing this debate on these important topics, and I commend him for setting out the importance of vaccines in combating so many diseases. When we look at the history of vaccination programmes in previous eras, we realise just what impact they have had on people’s lives.

We know that the covid vaccination programme is the nation’s best line of defence against covid-19. Vaccinated people are far less likely to face severe disease from covid-19, to be admitted to hospital or to die from it. They are also less likely to pass the virus to others. More than 93 million covid-19 vaccinations have already been administered, and the latest estimates from Public Health England indicate that the programme has saved more than 112,300 lives and prevented more than 24 million cases.

As other hon. Members have done, I pay tribute to everyone who has played a crucial role in the success of the vaccine roll-out—our brilliant scientists, clinical trial participants, the armed forces, NHS England, frontline healthcare workers, vaccine volunteers and local and central Government. Their life-saving efforts have helped to maintain the rapid pace of the roll-out across the entire country. I also recognise the brilliant work of the former Minister for vaccines, my right hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi). I know that I have very big shoes to fill.

The public’s continued willingness to get vaccinated, to test, to self-isolate if they have symptoms and to follow behaviours and actions that mitigate all methods of transmission has played a key role in the lifting of restrictions. Over autumn and winter, the Government will aim to sustain the progress made and prepare the country for future challenges, while ensuring that the national health service does not come under unsustainable pressure.

In my first debate as Minister with responsibility for vaccines, I join the plea of my hon. Friend the Member for Carshalton and Wallington and other hon. Members for those not yet vaccinated to take up their vaccine offer and join the around 89% of the UK who have had at least their first dose. I am sure the whole House will join me in thanking them for playing their part in helping us all to live safely.

We will continue to make vaccines easily available to everybody, to maximise uptake among those who are eligible but to date have not taken up the offer. In England, 11.3% of people ages 16 and older—more than 5.5 million people—remain unvaccinated, which heightens the risk of rising hospitalisations, particularly when prevalence is high. Take-up so far varies by ethnicity, age and deprivation, with some groups recording lower rates of vaccine uptake than others.

Building on lessons learned through phases 1 and 2 of the vaccine roll-out, the Government continue to work closely with the NHS to make it as easy as possible to get a vaccine, including through “Grab a Jab” in England, pop-up vaccine sites across the country and easy-to-use walk-in sites found on the NHS website. Pop-up sites include those at football stadiums and shopping centres, reaching out to the whole community. The Government have partnered with transport providers, such as Uber and FREE NOW to ensure access to vaccine sites is easier than ever before.

The hon. Member for Birmingham, Erdington (Jack Dromey) asked how the Government have reached out to people who are hesitant to take part in the vaccination programme. Despite having been in post for only a matter of days, I reassure him that the Government and the NHS are working closely together to ensure that we reach out and get the extra 5.5 million jabs into the arms that need them, and fill the gap that is in the community. I reassure him that that is one of my key priorities in my role as vaccine Minister.

The last 18 months have shown that the pandemic can change course rapidly and unexpectedly. It remains hard to predict with certainty what will happen. There are a number of variables, including the levels of vaccination, the extent to which immunity wanes over time, how quickly and how widely social contact returns to pre-pandemic levels, which is partly to do with the return to schools and as offices reopen, and whether a new variant emerges that fundamentally changes the Government’s assessment of the risk. That is why the autumn and winter plan sets out our plan B.

Vaccine status certification is part of the Government’s plan B if the data suggests action is required to prevent unsustainable pressure on the NHS. For venues, certification could allow settings that have experienced long periods of closure to remain open, compared to more stringent measures that may severely reduce capacity or cause them to close entirely. The autumn-winter plan committed to publishing further details shortly on the proposed certification regime that would be introduced as part of plan B.

In this scenario, certification would be introduced in a limited number of venues. Communal worship, wedding ceremonies, funerals and other commemorative events and protests would also not fall under the certification regime. Exemptions would continue to apply for those who cannot be vaccinated for medical reasons, those on covid vaccine clinical trials and for under-18s.

The NHS covid pass would continue to certify individuals based on vaccination, testing or natural immunity status, with more than 200 events and venues already introducing voluntary certification and the NHS covid pass as a condition of entry.

Care home staff provide a critical role in supporting the health and wellbeing of some of the most clinically vulnerable to the effects of covid-19 in society, and have maintained their dedication and professionalism through highly challenging conditions. Since the start of the pandemic, the Government have committed over £6 billion to local authorities through non-ringfenced grants to tackle the impact of covid-19 on their services, including adult social care. We continue to be committed to supporting the social care sector.

To prevent individual susceptibility to covid-19, from 11 November it will be a condition of deployment for anyone working or volunteering in Care Quality Commission regulated care homes that provide accommodation for persons who require nursing and personal care to be fully vaccinated. Thanks to the incredible efforts of people across the sector, over 1.2 million social care workers in England have now been vaccinated. This is a fantastic achievement and an important step for staff to protect themselves, their loved ones and the people they care for from becoming seriously ill or dying from covid-19.

[Graham Stringer]

Can the Minister answer the question that her predecessor failed to answer on the Floor of the House on Second Reading of the Bill? Everybody agrees that it would be a good idea if all care workers were vaccinated, but why will it be effective to force reluctant care workers to either have it or lose their employment, when other people entering care homes—hairdressers, musicians and entertainers and such—would not be forced to? How is that an effective policy?

[Maggie Throup]

I thank the hon. Gentleman for the question. If he will excuse me, I have obviously been in post a short time. As I am led to believe, it is people who regularly go into care homes that will need this. It is not just restricted to the actual carers. If anybody needs to go into a care home in an emergency situation, that is a different scenario. If I may, however, I will clarify that after the debate.

Vaccine uptake nationally in the care home workforce is high, at 85.6% for first doses. This is in line with vaccine uptake in the general population. There is, however, significant variation at a regional, local and individual care home level. Vaccine requirements are designed to level up uptake in the care home workforce. While the majority of care home workers have been vaccinated, the latest published data as of 12 September highlighted that only 81.3% of older adult care homes in England were meeting the SAGE advice that 80% uptake of first doses among staff is the minimum needed to reduce the risk of outbreaks in these high-risk care settings.

While residents in care homes are some of the most at risk from covid-19, the responses to this initial consultation on care homes made a clear case for extending this policy to other settings where vulnerable people receive care and treatments. The Government are therefore seeking views on whether to extend vaccination requirements to other frontline health and care workers—those with face-to-face contact with patients and clients through the delivery of services, as part of a CQC regulated activity. Recent research has shown that people infected with both flu and covid-19 are more than twice as likely to die as someone with covid-19 alone and nearly six times more likely than those with neither flu nor covid-19, so vaccination requirements for both flu and covid-19 are being considered.

I trust that the debate will have helped to dispel some of the myths that hon. Members have raised about vaccinations, and will really reach out to the public to ask them, as colleagues have done, to go and get vaccinated to protect themselves and others. To conclude, I reassure the House that we are doing everything we can to widen and deepen our wall of defence that the vaccine provides. The ask of our NHS colleagues is challenging and complex, yet they have risen to this challenge and do it every day. Once again, I thank them for their dedication.

Coronavirus

Graham Stringer Excerpts

Wednesday 16th June 2021 Commons Chamber

[Graham Stringer (Blackley and Broughton) (Lab)]

I will not be joining the Secretary of State in the Lobby later on, partly for civil liberties reasons, but I do agree with what he is saying about vaccination. About four years ago, the Science and Technology Committee looked at the level of flu vaccination in care homes, which at that time was about 20%. Flu, like covid, is a killer of elderly people. Will he be looking to make not only covid vaccination, but flu vaccination a condition of employment?

[Matt Hancock]

Yes we will, for exactly the reason that the hon. Gentleman sets out.

--- Later in debate ---

[Graham Stringer (Blackley and Broughton) (Lab)]

As ever, it is an honour to follow the hon. Member for Broxbourne (Sir Charles Walker). On his interesting point about SAGE, we could do with full disclosure from the Government about all the facts that they have available to them on covid. In the Science and Technology Committee this morning, we were told that vaccinations have saved 14,000 lives. I have no doubt that that is an accurate figure, but there are many figures that have not been given. As we said the last time we debated this issue, only one side of the equation is given. Let me ask this question: how many lives have been lost in order to save capacity in the NHS? When it comes to looking at people untested and untreated for cancer, heart disease and other diseases, we will find that the figures are of a similar, if not greater, magnitude than the number of people who have died from covid.

We should have transparency and open declarations of what really happened with the 26,000 deaths in care homes, where untested people were sent from hospital. We should have disclosure about all those people who were triaged by age and who were not treated, and all those people in care homes who were not allowed into hospitals because they were not taking people from care homes. There is a great deal more information that we require in order to make a rational decision about whether the lockdown should continue. I agree with the right hon. Member for New Forest West (Sir Desmond Swayne) that what we have here is the Government asking for emergency powers when there is no longer an emergency.

[Aaron Bell (Newcastle-under-Lyme) (Con)]

I thank the hon. Gentleman for giving way; we were in the Science and Technology Committee this morning. Does he share my disquiet at the fact that the vaccine effectiveness numbers that Public Health England has published—96% effectiveness against hospitalisation from two doses of Pfizer, and 92% from Oxford-AstraZeneca—are much higher than the numbers that have been plugged into the models used by Imperial and the London School of Hygiene and Medical to underpin the data that the Government are relying on?

[Graham Stringer]

I agree completely that those sorts of numbers—the real numbers, as opposed to model numbers—are the numbers that should have been plugged into that model. They would have given a different scenario. The hon. Gentleman makes my point: in order to come to rational decisions about what risks we should take as a country and what risks individuals should take, we should have all the information up to date and available. The Government have refused on a number of occasions to give out that information. They have run a campaign to scare people into accepting their decisions.

To go back to the comments of the hon. Member for Broxbourne, who was talking about elections to SAGE, at least the behavioural psychologists who advise the Government have made a public apology. They say that they have undermined their professional credibility by joining the campaign of fear. I wish that the Government would not only put out more information, but apologise for frightening people. They should not frighten the electorate, and they certainly should not frighten people in this Chamber into taking people’s liberties away.

One of the things that has annoyed me most in the last 15 months is when the Prime Minister and the Secretary of State for Health and Social Care say, “We instruct you”—meaning the population—“to do various things,” when there is nothing in the legislation that would give the Secretary of State or the Prime Minister the ability to instruct individuals. We live in a liberal democracy in which we pass laws that are enforced by the police, and then the courts make a decision if there is a prosecution, not one in which the Secretary of State acts like some kind of uniformed Minister of the Interior.

I will vote against the regulations today. We need a more direct debate on the issue and we need what Members have searched for—a straightforward comparison, with real statistics, of what risks everybody faces.

Air Ambulance Funding

Graham Stringer Excerpts

Monday 26th April 2021 Westminster Hall

[Graham Stringer (in the Chair)]

I remind hon. Members that there have been some changes to normal practice, in order to support the new hybrid arrangements. Timings of debates have been amended to allow technical arrangements to be made for the next debate. There will also be suspensions between each debate. I remind Members participating physically and virtually that they must arrive for the start of debates in Westminster Hall. Members are expected to remain for the entire debate. I must also remind Members participating virtually that they are visible at all times, both to each other and to us in the Boothroyd Room. If Members attending virtually have any technical problems they should email the Westminster Hall Clerks email address. Members attending physically should clean their spaces before they use them and as they leave the room. I would also like to remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall—obviously not when speaking.

Coronavirus

Graham Stringer Excerpts

Thursday 25th March 2021 Commons Chamber

[Jonathan Ashworth]

The hon. Gentleman invites me to offer endorsement before I have read the details—he is a canny operator in this place—but in principle his suggestion sounds reasonable. I look forward to no doubt receiving an email from him later today, which I will be able to read when I am on the train back to Leicester.

[Graham Stringer (Blackley and Broughton) (Lab)]

My hon. Friend is giving us an interesting insight into the history of the epidemic in this country and the discussions that took place. Would he care to put it on record that we should immediately start an independent public inquiry into what has gone on so that we can get a full picture? It is a feeble excuse to say that people cannot attend a public inquiry when virtually every Select Committee in this House is having witnesses every day.

[Jonathan Ashworth]

My hon. Friend is absolutely right: we need a public inquiry. Mistakes have been made. There have been examples of poor decision making. When we went into the crisis, our health and social care capacity was less than it should have been, and our public health capacity, after cutbacks over many years, was lacking. We were late going into lockdown a year ago; maybe that was not unreasonable, but we were also late going into lockdown the second and third time. Of course we need a public inquiry to get to the bottom of all these matters.

The Secretary of State is embarking on a reorganisation of the national health service. Yesterday, he made an interesting speech about the future of public health, which he opened by saying that one lesson of this crisis is that we need to set up a national institute of health security. I agree with him on health security, as it happens, but the Government cannot, on the one hand, say that they have learned lessons from this crisis and they need to do X, Y and Z while, on the other hand, the Prime Minister says it is too early to learn lessons and we cannot have an inquiry. My hon. Friend the Member for Blackley and Broughton (Graham Stringer) is absolutely right and I totally agree with him.

We have concerns about schedule 21 of the 2020 Act, but we are where we are, and the procedures of the House leave us little room for manoeuvre, so we will support the Government in the Division Lobby, should it come to that, albeit that we would rather not be in this situation.

Schedule 22 is another schedule that is open to abuse, and I hope the Government will review it and come forward with alternatives; given recent events, the power it contains on gatherings has caused understandable concern. However, some progress is offered by the public health regulations, which expressly include—I think for the first time, and in relation to each step of lockdown relaxation—the right to gather for purposes of protest. That is welcome but, to be frank, it should have been there all along. I have some concerns that, to comply, organisers must take into account, in the words of the regulations,

“any guidance issued by the government relevant to the gathering”,

which means that the Government, through guidance, which could be general or specific to a particular protest, can determine what is allowed by way of protest. I hope the Minister, who is a decent man and a fellow Leicestershire MP, can offer us some guidance on that in his response.

Notwithstanding our concerns, we understand why the 2020 Act must stay on the statute book and why the public health regulations must receive the support of the House today. The pandemic is not over. The virus is surging again. Deaths are increasing across the world after going down for some weeks. Mutations could emerge, which could bounce back at us and set us back considerably. Although they would probably not put us back to square one, they could evade the success of our vaccination programme. A year ago, I concluded my remarks by observing:

“The crisis has exposed the vulnerability of a society in which insecure work is rife, deregulation is king and public services are underfunded. When we come out on the other side, as we will, we have to build a society that puts people first.”—[Official Report, 23 March 2020; Vol. 674, c. 61.]

Rebuilding that society becomes ever more urgent every day.

--- Later in debate ---

[Graham Stringer (Blackley and Broughton) (Lab)]

It is a pleasure to follow the hon. Member for Broxbourne (Sir Charles Walker).

On 7 March in Manchester there was a demonstration, not about milk but about the pay of NHS staff. Karen Reissmann, a political opponent of mine at general elections, was arrested and served with a fine of £10,000. That is an extraordinary attack on civil liberties. The very small group of people at the demonstration were socially distanced. Professor Woolhouse has told the Science and Technology Committee that while no risk is zero, the risk of catching covid-19 in the open air is minimal. We need to stop these restrictions now. That is one of the reasons why I will not be voting for the Government’s proposals.

The second point I want to make is about the Government’s statement that they believe in “data, not dates”. That is a curious thing for them to say, because when you look at what they say, there is no data there. There are dates—lots of dates—and when we have asked Ministers and scientists, how we, as parliamentarians can check the data to see whether things are going well or badly, and so that we can ask for it to be speeded up, no information is given to us. Quite simply, it is a slogan. The Government should be telling us what level of admission into intensive care, what level of infections, what level of hospital admissions and what level of vaccinations could lead to us being freed earlier. That is another reason why I will not be voting for the proposals before us; they are not giving Members of Parliament the tools that they need to deal with this.

My third point, in some ways my most fundamental point, is that we have only ever been given one side of the story. People have died of covid, but if we look at what the cancer charities are telling us at the present time, we will see that at least 50,000 people are expected to die because they have not been tested over the past 12 months. Every area of health service provision has been diminished because of the actions that have been taken on covid.

I cannot get past this point without also highlighting what Patrick Vallance told the Science and Technology Committee. If we had had the same level of intensive care facilities as Germany and France—they have about five times the level that we have—many of those other services could still have been provided. We have lost jobs. School children will suffer for the rest of their lives—hopefully not, but I think that that is the case—because of what has been done to protect people.

I cannot support what the Government propose. The big reason behind it, I suppose, is that Governments can get a taste for authoritarianism and for large powers. I do not want them to get a taste for that. I want this to be the end of it. I would like it to be the end of it today, or in six months, or on 21 June. I think that is unlikely, but I do not want this or any other Government to think that we should give these powers to a Government ever again.

Deaths in Mental Health Care

Graham Stringer Excerpts

Monday 30th November 2020 Westminster Hall

[Graham Stringer (in the Chair)]

Before we start, I remind hon. Members of the new rules in Westminster Hall. They should be getting used to them now, but some have not been in a Westminster Hall debate. I ask Members to sanitise their microphones using the cleaning materials provided before they use them, and dispose of the materials as they leave the Chamber. Members are also expected to honour the one-way system, which means going round clockwise, coming in by the left entrance and leaving by the other entrance. Members can intervene only if they are on the call list. If you are on the call list, you are expected to be here at the start of debate but, unlike the position prior to covid, it is quite permissible to leave after having spoken.

Before I call the hon. Member for Hartlepool (Mike Hill), I need to advise hon. Members that I have been informed that there are active Health and Safety Executive criminal legal proceedings against Essex Partnership University NHS Foundation Trust relating to deaths in mental health care facilities between October 2004 and April 2015. I have further been informed that the trust has pleaded guilty in those proceedings to failures of care relating to the deaths of 11 patients. Active proceedings are sub judice until sentencing or discontinuance under the House’s resolution. Therefore, Members should be mindful of matters still before the court—in particular, the judgment and sentencing in this case.

--- Later in debate ---

[Mike Hill]

The statement reads:

“I am mum to Matthew James Leahy, born December 1991. He was a beautiful soul. He understood compassion and he cared for others. He was generous, he was kind, he was smart. He was funny and in his younger years he wanted to be a comedian. He was quite shy in large groups, and was a loyal friend. He was never one to encourage a fight but he would stand up for himself and the ones he loved. And I’m proud to say my son was honest, not a liar, not like some I’ve come across on this journey.

He loved the outdoors, loved anything water sports related and was a fantastic skier. Having left Grammar school, where he excelled in mathematics and computer science, he set up his own computer business, travelling between clients on his motorbike and was doing really well. He had a natural talent for swimming. He actually saved two ladies from drowning and when 18 he became a qualified life guard.

Aged 19 Matthew was having trouble sleeping and complaining of pains in his stomach and having stomach cramps. He was also hallucinating. When Matthew became poorly we turned to so called professionals for help, to help us to understand what was happening with our son. He was sectioned for care and treatment. This sectioning and the failings in care at that time, although noted briefly in the inquest verdicts, have never been investigated.

After Matthew’s death medical records showed that the first psychiatrist involved in his care picked up a B12 and folate deficiency and possible coeliac disease, combined with a thyroid issue. However, these discoveries were never addressed, as a new psychiatrist took over Matthew’s care and put him straight on to anti-psychotic medication. Any further physical checks were minimal.

On 7 November 2012, Matthew was placed under section 3 of the Mental Health Act and admitted to the Linden Centre in Chelmsford, Essex. By 15 November, some seven days in the ‘care of the state’, my son was dead. The last days of his life in a place he called ‘Hell’. And I now believe it truly was a hell on earth.

Alone, malnourished, over-medicated, scared, bleeding, bruised, reportedly raped, injected multiple times, ignored, and frightened. No records of any staff in those last seven days of his life offering him any comfort. I had been advised not to visit and to give him time to settle on the ward. I will live with the guilt for the rest of my life that I listened to so-called professionals and I was not there when my son needed me the most.

An inquest into my son’s death was held in January 2015. An open narrative verdict was reached, which concluded that my son, ‘Matthew James Leahy was subject to a series of multiple failings and missed opportunities over a prolonged period of time by those entrusted with his care. The jury found that relevant policies and procedures were not adhered to, impacting on Matthew’s overall care and wellbeing leading up to his death.’

How the inquest concluded I will never know. Staff were not interviewed by police after Matthew’s death. An internal investigation was carried out, which the Parliamentary and Health Service ombudsman has deemed flawed and not fit for purpose. This flawed investigation formed the basis of every investigation actioned after Matthew’s death.

The ligature was destroyed, the defibrillator was destroyed. Door logs were not downloaded. CCTV was hidden for over seven-plus years, and parts of it either not retained or deleted. So, so many more issues exist.

I have not been able to determine or control any of this—investigations, reviews, reports etc—all processes that have happened around me, with me being entitled to some information and some explanation, but little voice, little influence and little power.

I did think that the system would be open and honest, would explain what went wrong, hold to account those responsible for any failings and afford justice for failing my most precious son. However, I have discovered a deeply troubling mismatch between what I expected and what I found. In any other walk of life, if there had been failings, heads would roll. This has never happened, despite criminal offences being proved.

If the tragedy of losing Matthew hasn’t been bad enough, to not know the full circumstance that led to his death ‘whilst in the care of the state’ is unforgiveable. I still do not have full disclosure and have never seen internal statements. ‘Duty of Candour’ went out of the window the moment Matthew died.

It came to light after Matthew died that paperwork had been falsified, backdated and slipped into his files. It took me four-plus years to finally persuade Essex Police to register this falsification of mental health documents as a crime. I thought, ‘At last, they are listening to me.’ Then the bomb dropped. ‘We won’t be prosecuting, as it’s not in the public interest.’

The Trust has failed to take steps to protect patients in their care. The question remains why no individual has been held to account and why some staff involved in failing my son and other patients have actually been promoted to high-ranking positions within the NHS.

The Coroner called for a Public Inquiry after the inquest in 2015. There have also been multiple calls from various MPs in the last five years. The Parliamentary and Health Service Ombudsman went on national television after ‘The Missed Opportunities Report’ was published to say that if he had the power to, he would call a Public Inquiry.

In October last year, the Public Administration and Constitutional Affairs Committee held an evidence session on the Ombudsman’s Report into the failed care of Matthew and of Ben Morris. (Ben died in the Linden Centre in 2008 aged 20 years).

During the session, the Minister for Patient Safety, Mental Health and Suicide Prevention explained, ‘that Public Inquiries do not happen for individual cases. In this case, a Public Inquiry is not an appropriate response because we are talking about two cases’.

I have now been joined in this fight calling for a Statutory Public Inquiry into Essex Mental Health Services by multiple bereaved and failed families. (55 families and growing). How multiple deaths can have gone on unchallenged for so many years and so many people in official positions, not involved with this scandal, have entrapped themselves by collaboration the moment they came across it has baffled me. How the system did not prevent these deaths or at the very least detect the failings/changes needed earlier I’m sure is a question in many failed families’ minds, not just mine.

Where is the Government’s anger? Its thirst for Truth and Justice? Its commitment to getting answers and ensuring it never happens again?

Many families are losing loved ones while under the care of state mental health system. Whether that be due to mental illness, additional vulnerabilities such as autistic and/or learning disabled individuals, those misdiagnosed, or dementia...it does not discriminate.”

The Government are now officially, in Melanie’s words,

“on notice of…Gross and systemic Neglect (resulting in multiple avoidable deaths)…Physical, sexual, and emotional abuse and exploitation of the vulnerable—most of them young, historical and sadly, ongoing.

The right people in Government need to understand the full extent of the Essex Trust’s Failures and I have every faith that once the Government commits to a Full Statutory Public Inquiry into Essex Mental Health, the fundamental truth of what and still is going wrong will be revealed.

Through that knowledge I hope justice and accountability are afforded and that necessary change is made for others who, like I and many others did, look to services when they need safe, compassionate care for their loved ones.”

I have to echo that point in respect of some horrendous cases in the Tees Valley, my own patch.

I will conclude with the following words:

“I offered the Government Matthew’s sad death to be a catalyst of learning and change months ago. Please call a Public Inquiry into Essex Mental Health Services without further delay. Make the changes in Essex and send the learning across the country. I hope then that I can start to grieve the loss of my son and Matthew will be able to then rest in peace.”

I know I have kept my speech narrow, but I felt it appropriate to reflect the true voice of the petitioners. Thank you, Mr Stringer, for allowing me to do that.

[Graham Stringer (in the Chair)]

There are a number of people on the list who wish to speak. I will start with a time limit of four minutes, and call James Cartlidge.

--- Later in debate ---

[Janet Daby (Lewisham East) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Stringer. The circumstances of the debate are truly heartbreaking. I begin by extending my condolences to the family of the late Matthew Leahy and all families who have lost loved ones with mental illness at the hands of those who were supposed to protect them and care for them.

For many decades, mental health has not received enough attention or funding in comparison with physical illness. I draw attention to the mental health unit in Lewisham, which has already been viewed as not being fit for purpose—it was not built for people who have mental health problems—yet funding has never materialised for the changes needed to make it suitable for people with mental health problems. With the pressures of the pandemic, medical professionals are reporting more and more that people are suffering with mental illness due to economic hardship or loneliness, so it is clear there will be greater demand for mental health services over the next few years. It is imperative that we have well-functioning and well-funded mental health services to prevent needless deaths of the most vulnerable who are in need of those services. Medical professionals, the police and everybody around them also need support to be able to care for people with mental health illnesses. They need training, supervision and, most of all, not to be overworked. They also need to be able to debrief when they find things difficult.

I would like to raise the case of the late Kevin Clarke, from my constituency of Lewisham East, who sadly died following a mental health relapse. My condolences go out to his family, who are still bereft from the loss of Kevin, who, despite not posing an immediate threat to anyone, was handcuffed and placed in a leg restraint while telling the police that he could not breathe. In October, an inquest concluded that the officer’s restraint and supervision towards Kevin were excessive and sadly contributed to his death. However, the police were not the only professionals involved in his care. Other professionals were also in contact with him prior to this tragic incident.

A strategy of care needs to be in place for all mental health patients, one in which patients are listened to and family members are involved, so that loved ones can talk about preventative measures and their concerns, as well as contribute to the care plans that are needed. Mental health doctors, mental health nurses, social workers and care staff all need to work collaboratively with all professionals involved in keeping the most vulnerable people safe and secure, and to prevent these fatal, awful incidents of suicide or types of restraints leading to death. Change needs to happen.

[Graham Stringer (in the Chair)]

Hon. Members have either not turned up or taken less time than expected, so, unusually, I will increase the time limit for the last speakers to five minutes.

--- Later in debate ---

[Dr Allin-Khan]

Yes, of course it would be in everyone’s best interests for the inquiry to take place as soon as possible. After all this time, Melanie deserves some answers. I support her call for a statutory public inquiry into Essex mental health services and for the appointment of an independent chair. It is crucial that lessons are learned from Matthew’s case.

I will take this moment to read a few words from Melanie about why a statutory public inquiry is so important to her:

“To come this far and then get fobbed off with a review or general inquiry…would simply take…us all back to square one.”

She goes on to ask that the Minister do something real and meaningful that paves the way for truth, justice, accountability and change. There is an opportunity here for the Minister to commit to providing a grieving mother with answers about her son’s death, and to learning lessons so that other families do not suffer in this way. We cannot, and must not, delay any further.

[Graham Stringer (in the Chair)]

We have plenty of time, but I ask the Minister to leave enough time for the wind-up at the end.